Individual provider Active NPI

Dana Lara Wolfe, NP-C

  • Family Nurse Practitioner
  • Southgate, MI
National Provider Identifier
1033125802
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704154939 Issued in MI
Practice address
16525 Fort St
Southgate, MI 48195-1403
Phone
(734) 250-9529
NPI assigned
Jul 31, 2006
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2997 SC
Family Nurse Practitioner 363LF0000X 4704154939 MI Primary

Addresses

Primary practice location

16525 Fort St
Southgate, MI 48195-1403

Mailing address

23296 Stoflet LN
Trenton, MI 48183-5408
Phone (843) 250-1895

Other practice location 1

233 Brickle St
Bamberg, SC 29003-2021
Phone (843) 250-1895

Other identifiers 4

IdentifierTypeStateIssuer
NP1747MedicaidSC
P00906569OtherSCRAILROAD MEDICARE PTAN
4704154939OtherMILICENSE #
2997OtherSCLICENSE #

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
I20180813003459 MI Practitioner - Nurse Practitioner 7618970617 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

16525 Fort St
Southgate, MI 48195-1403
Phone (734) 250-9529

18930 W Rd
Beaumont Urgent Care of Michigan
Woodhaven, MI 48183-3317
Phone (734) 671-4900

2078 E Big Beaver Rd
Beaumont Urgent Care of Michigan
Troy, MI 48083-2301
Phone (248) 918-0744

23100 Michigan Ave
Dearborn, MI 48124-2033
Phone (313) 263-7584

9870 Telegraph Rd
Taylor, MI 48180-3399
Phone (313) 291-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704154939MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commerce Sports and Spine PLLC CurrentSince Feb 17, 2022 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Hometown Urgent Care of Michigan, PC CurrentSince Nov 16, 2021 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Nov 16, 2021 Accepting new patients
Wellstreet Urgent Care of Michigan CurrentSince Jun 28, 2022 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

3550 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-2530

29877 Telegraph Rd
Ste 400
Southfield, MI 48034
Phone (248) 294-0539

16525 Fort St
Southgate, MI 48195
Phone (734) 250-9529

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

Organizations & group practices 6

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

Hospital & facility affiliations 3

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1033125802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23296 STOFLET LN",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481835408",
            "telephone_number": "843-250-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16525 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951403",
            "telephone_number": "734-250-9529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "233 Brickle St",
            "address_purpose": "LOCATION",
            "city": "Bamberg",
            "state": "SC",
            "postal_code": "290032021",
            "country_code": "US",
            "telephone_number": "843-250-1895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "DANA",
        "middle_name": "LARA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "2997",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704154939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1747",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00906569",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "4704154939",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "2997",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.