Individual provider Active NPI

Vanessa Stevens, FNP-BC

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1023867843
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28594 Issued in SC
Practice address
5165 Northland Dr NE
Grand Rapids, MI 49525-1015
Phone
(843) 990-1965
NPI assigned
May 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28594 SC Primary
Nurse Practitioner 363L00000X 4704245528 MI
Nurse Practitioner 363L00000X 80009 NM

Addresses

Primary practice location

5165 Northland Dr NE
Grand Rapids, MI 49525-1015

Mailing address

3559 Rookwood PL
Johns Island, SC 29455-8184
Phone (843) 990-1965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223000732 MI Practitioner - Nurse Practitioner 9133656622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 E Michigan Ave
Mercy Grayling Hopsital
Grayling, MI 49738-1334
Phone (989) 348-5461

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704245528MIMDNurse Practitioner
80009NMMDNurse Practitioner
28594SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Primary Health LLC Current Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Nurse Practitioner Current Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC CurrentSince Oct 20, 2024 Accepting new patients

Locations

5165 Northland Dr NE
Grand Rapids, MI 49525
Phone (616) 466-4068

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1023867843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3559 ROOKWOOD PL",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294558184",
            "telephone_number": "843-990-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5165 NORTHLAND DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251015",
            "telephone_number": "843-990-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "VANESSA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "28594",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704245528",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "80009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.