Individual provider Active NPI

Tyler McLaughlan, FNP

  • Family Nurse Practitioner
  • Shelby Township, MI
National Provider Identifier
1053152504
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704357555 Issued in MI
Practice address
14270 Oakwood Dr
Shelby Township, MI 48315-1450
Phone
(586) 900-9444
NPI assigned
Jun 6, 2024
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704357555 MI Primary

Addresses

Primary practice location

14270 Oakwood Dr
Shelby Township, MI 48315-1450

Mailing address

14270 Oakwood Dr
Shelby Township, MI 48315-1450
Phone (586) 900-9444

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
I20240925000553 MI Practitioner - Nurse Practitioner 5890236210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical CurrentSince Jul 8, 2024 Accepting new patients

Locations

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

2525 Demille Blvd
Lapeer, MI 48446
Phone (313) 590-9170

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1053152504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14270 OAKWOOD DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483151450",
            "telephone_number": "586-900-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14270 OAKWOOD DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483151450",
            "telephone_number": "586-900-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLAN",
        "first_name": "TYLER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704357555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.