Individual provider Active NPI

Lauren Ann Boury, NP

  • Acute Care Nurse Practitioner
  • Oak Park, MI
National Provider Identifier
1063929552
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704286459 Issued in MI
Practice address
20770 Greenfield Rd
Oak Park, MI 48237-3018
Phone
(248) 967-0026
NPI assigned
Jan 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704286459 MI Primary

Addresses

Primary practice location

20770 Greenfield Rd
Oak Park, MI 48237-3018

Mailing address

31107 Angeline CT E
Saint Clair Shores, MI 48082-1441
Phone (586) 214-8336

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Physiatrists PC 16 clinicians

Practice addresses (Care Compare)

50505 Schoenherr Rd
Suite 210
Shelby Township, MI 48315-3140
Phone (586) 884-6681

Merit-based Incentive Payment System (MIPS)

Final score
94.92 of 100Reported as group
Quality
93.88
Improvement activities
40
Cost
69.43

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
I20190311002569 MI Practitioner - Nurse Practitioner 1456690395 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704286459MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Physiatrists PC CurrentSince Mar 8, 2019 Accepting new patients

Locations

8301 Reliable Pkwy
Chicago, IL 60686

50505 Schoenherr Rd
Ste 210
Shelby Township, MI 48315
Phone (586) 884-6681

25311 Little Mack Ave
Ste B
St Clr Shores, MI 48081
Phone (586) 498-2400

Interoperability endpoints

  • Direct secure messaging: lboury1118348@direct.hfhs.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHCEBA/Endpoint/IHCEBA

NPI Registry JSON

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1063929552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31107 ANGELINE CT E",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821441",
            "telephone_number": "586-214-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20770 GREENFIELD RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373018",
            "telephone_number": "248-967-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURY",
        "first_name": "LAUREN",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704286459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

Verify at the official NPI Registry.