Individual provider Active NPI

Danielle Lynn Leblanc, NP-C

  • Family Nurse Practitioner
  • Brimley, MI
National Provider Identifier
1053923763
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704290592 Issued in MI
Practice address
12455 W Lakeshore Dr.,
Brimley, MI 49715
Phone
(906) 248-5527
NPI assigned
Aug 24, 2020
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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 4704290592 MI Primary

Addresses

Primary practice location

12455 W Lakeshore Dr.,
Brimley, MI 49715

Mailing address

12124 W Lakeshore Dr
Brimley, MI 49715-9319
Phone (906) 248-5527

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
I20200928002088 MI Practitioner - Nurse Practitioner 9032538806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Mills Indian CommunityGroup PAC ID 8729079918, 13 clinicians

Practice addresses (Care Compare)

12140 W Lakeshore Dr
Brimley, MI 49715-9319

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704290592MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Mills Indian Community Current Accepting new patients
Bay Mills Indian Community CurrentSince Sep 16, 2020 Accepting new patients
Bay Mills Indian Community CurrentSince Sep 16, 2020 Accepting new patients

Locations

12124 W Lakeshore Dr
Brimley, MI 49715
Phone (906) 248-5527

12455 W Lakeshore Dr
Brimley, MI 49715
Phone (906) 248-5527

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1053923763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12124 W LAKESHORE DR",
            "city": "BRIMLEY",
            "state": "MI",
            "postal_code": "497159319",
            "telephone_number": "906-248-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 W LAKESHORE DR.,",
            "city": "BRIMLEY",
            "state": "MI",
            "postal_code": "49715",
            "telephone_number": "906-248-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "DANIELLE",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704290592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brimley, MI

Sources for this page

Verify at the official NPI Registry.