Active NPI
Joanna Lois Maynard, NP
- Family Nurse Practitioner
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704195287
- Practice address
- 1500 E Medical Center Dr
Ann Arbor, MI 48109-5000 - Phone
- (734) 936-4000
- NPI assigned
- Oct 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704195287 | MI | |
| Family Nurse Practitioner | 363LF0000X | 4704195287 | MI | Primary |
Addresses
Primary practice location
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003822412 | Other | MI | BCBSM - BRONSON |
| 1003822412 | Other | MI | BCBSM |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.bronsonhg.org | Direct |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704195287 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronson Methodist Hospital | Current | Accepting new patients | |
| Regents of the University of Michigan | Nurse Practitioner | Current | Accepting new patients |
| Regents of the University of Michigan | Current | Accepting new patients | |
| Regents of the University of Michigan | Past | Accepting new patients |
Locations
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229
601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500
601 John St
Ste M-351
Kalamazoo, MI 49007
Phone (269) 341-8786
601 John St
Ste W-308
Kalamazoo, MI 49007
Phone (269) 341-8827
601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100
6563 W Main St
Kalamazoo, MI 49009
Phone (269) 233-9191
Interoperability endpoints
- jmaynard6960@direct.bronsonhg.org
- direct@direct.bronsonhg.org
Organizations & group practices 4
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.
-
- Hospitalist Physician
- Kalamazoo, MI
- NPI 1417961137
-
- Nurse Practitioner
- Ann Arbor, MI
- NPI 1447275102
-
- Specialty Pharmacy
- Dexter, MI
- NPI 1952181919
-
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1043461874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081633",
"telephone_number": "734-647-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481095000",
"telephone_number": "734-936-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNARD",
"first_name": "JOANNA",
"middle_name": "LOIS",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-10",
"last_updated": "2023-11-27",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704195287",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704195287",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM - BRONSON",
"identifier": "1003822412",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "1003822412",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@direct.bronsonhg.org",
"affiliation": "Y",
"endpointDescription": "Bronson Healthcare Group Direct address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Continuity of Care Document",
"address_1": "601 John St",
"city": "Kalamazoo",
"state": "MI",
"country_code": "US",
"postal_code": "490075341",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.