Laura Ackerman, CFNP
Individual provider Active NPI Family Nurse Practitioner · Grand Rapids, MI
NPI 1063449585 · NPPES record last updated Nov 23, 2016
Key facts
- NPI
- 1063449585
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704235109 (MI)
- Practice address
- 250 Cherry St SE
Grand Rapids, MI 49503-4608 - Phone
- (616) 685-5600
- Fax
- (616) 685-6745
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advantage Health/Saint Mary'S Medical Group
Practice addresses (Care Compare)
10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850
220 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5050
250 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5600
Hospital & facility affiliations
- Mercy Health Saint Mary'S
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060310000245 | MI | Practitioner - Nurse Practitioner | 2567479827 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Health/Saint Mary'S Medical Group | Current |
Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Current |
Accepting new patients | |
| Hastings Internal Medicine PLC | Past |
Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Past | Accepting new patients | |
| Trinity Health - Michigan | Past | Accepting new patients | |
| Saint Mary'S Health Services | Past | Accepting new patients |
Locations
10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850
245 State St SE
Ste 1A
Grand Rapids, MI 49503
250 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 685-5600
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BBFDAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704235109 | MI | Yes |
Addresses
Primary practice location
250 Cherry St SE
Grand Rapids, MI 49503-4608
Mailing address
1900 44TH St SE
Kentwood, MI 49508-5008
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200338221 | Other | MI | TRICARE |
| 5008705720 | Other | MA | BCBSM |
| 4823034 | Medicaid | MI |
Other names
- Laura Gelderloos
Other providers in Grand Rapids, MI
- Travis Achterhof
- Eric D Achtyes
- Katie Elizabeth Achtyes
- Emily Ackerberg
- Alyssa Ackerman
- Shari L. Ackerman
- Aaron Jeremy Ackley
- Amelia Sue Ackley
- Cierra Rose Ackley
- Jerry Ackley
All providers in Grand Rapids, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.