Individual provider Active NPI

Deanna Wennberg, FNP-C

  • Family Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1053772830
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704242410 Issued in MI
Practice address
1215 E. Michigan Avenue
Lansing, MI 48912
Phone
(517) 364-1000
NPI assigned
Mar 8, 2016
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 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 4704242410 MI Primary

Addresses

Primary practice location

1215 E. Michigan Avenue
Lansing, MI 48912

Mailing address

1200 E Michigan Ave Ste 101
Lansing, MI 48912-1800
Phone (517) 364-5552

Other practice location 1

2682 E Grand River Ave
East Lansing, MI 48823-5608
Phone (517) 333-6562

Other practice location 2

800 E Columbia St
Mason, MI 48854-1381
Phone (517) 244-8900

Other practice location 3

1120 E Michigan Ave Ste A
Lansing, MI 48912-1810
Phone (517) 364-9790

Other practice location 4

1015 Charlevoix Dr
Grand Ledge, MI 48837-2278
Phone (517) 627-0100

Other practice location 5

2682 E Grand River Ave
East Lansing, MI 48823-5608
Phone (517) 333-6562

Other practice location 6

1200 E Michigan Ave Ste 101
Lansing, MI 48912-1800
Phone (517) 364-5552

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
I20160324000263 MI Practitioner - Nurse Practitioner 5799082418 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, shared by 20 NPIs, 698 clinicians

Practice addresses (Care Compare)

2900 Hannah Blvd
East Lansing, MI 48823-5384
Phone (517) 364-5552

2900 Hannah Blvd
Suite 212
East Lansing, MI 48823-5382
Phone (517) 364-8890

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704242410MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince Dec 1, 2024 Accepting new patients
Edward W Sparrow Hospital Association Nurse Practitioner CurrentSince Nov 1, 2024 Accepting new patients
Sparrow Ionia Hospital CurrentSince Dec 1, 2024 Accepting new patients
Sparrow Carson Hospital CurrentSince Dec 1, 2024 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Apr 1, 2016 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

102 S 3rd St
Ste 100
Carson City, MI 48811
Phone (989) 584-1308

2682 E Grand River Ave
East Lansing, MI 48823
Phone (517) 333-6352

2900 Hannah Blvd
Ste 212
East Lansing, MI 48823
Phone (517) 319-1831

1015 Charlevoix Dr
Grand Ledge, MI 48837
Phone (517) 627-0100

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1004 E Michigan Ave
Lansing, MI 48912
Phone (517) 364-9790

1120 E Michigan Ave
Ste A
Lansing, MI 48912
Phone (517) 364-9777

1200 E Michigan Ave
Ste 101
Lansing, MI 48912
Phone (517) 364-5552

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

Interoperability endpoints

  • Direct secure messaging: dwennberg50348@sparrowdirecthie.org

Organizations & group practices 9

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 2

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": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1053772830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121800",
            "telephone_number": "517-364-5552",
            "fax_number": "517-364-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E. MICHIGAN AVENUE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2682 E Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488235608",
            "country_code": "US",
            "telephone_number": "517-333-6562",
            "fax_number": "517-333-6563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Columbia St",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "MI",
            "postal_code": "488541381",
            "country_code": "US",
            "telephone_number": "517-244-8900",
            "fax_number": "517-244-8911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 E Michigan Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121810",
            "country_code": "US",
            "telephone_number": "517-364-9790",
            "fax_number": "517-364-9791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Charlevoix Dr",
            "address_purpose": "LOCATION",
            "city": "Grand Ledge",
            "state": "MI",
            "postal_code": "488372278",
            "country_code": "US",
            "telephone_number": "517-627-0100",
            "fax_number": "517-627-0150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2682 E Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488235608",
            "country_code": "US",
            "telephone_number": "517-333-6562",
            "fax_number": "517-333-6563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 E Michigan Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121800",
            "country_code": "US",
            "telephone_number": "517-364-5552",
            "fax_number": "517-364-5544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENNBERG",
        "first_name": "DEANNA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704242410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.