Tynise La'Shaie Penn, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704240129 Issued in MI

Practice address

405 W Greenlawn Ave Ste G11
Lansing, MI 48910-2889

Phone

(313) 346-4240

Fax

(313) 346-4241

NPI assigned

Dec 3, 2009

Last updated

Oct 16, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tynise La'Shaie Gray Former name

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Commerce Sports and Spine PLLCGroup PAC ID 3870926397, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13320/brand/1/csg/1/fhir/r4

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.

• Commerce Sports and Spine PLLC

  • Psychiatry Physician
  • Southfield, MI
  • NPI 1720629157
  Medicare reassignment Care Compare group NPD
• Virtual Wellness Care, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lansing, MI
  • NPI 1447190020

  Nurse Practitioner

  Medicare reassignment NPD Authorized official
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI, Nurse Practitioner

  Medicare reassignment NPD
• Life Line Psychiatric Services

  • Psychiatry Physician
  • Center Line, MI
  • NPI 1285064063
  NPD (past)
• Onsight, Inc.

  • Podiatrist
  • East Lansing, MI
  • NPI 1821248568
  NPD (past)
• Quest Diagnostics Incorporated Mi

  • Clinical Medical Laboratory
  • Royal Oak, MI
  • NPI 1689084667
  NPD (past)
• St Clair Specialty Physicians PC

  dba St. Clair Nephrology, Idaho Nephrology Associates

  • Nephrology Physician
  • Roseville, MI
  • NPI 1154361616
  NPD (past)
• Vpa PC

  • Family Medicine Physician
  • Fort Gratiot, MI
  • NPI 1962516286
  NPD (past)
• Giaimo Mobile Podiatry of WV PLLC

  • Podiatrist
  • Charleston, WV
  • NPI 1386183473
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  Care Compare affiliation

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1073841011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31355 BRETZ DR",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935532",
            "telephone_number": "313-350-1657",
            "fax_number": "313-346-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GREENLAWN AVE STE G11",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102889",
            "telephone_number": "313-346-4240",
            "fax_number": "313-346-4241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29877 Telegraph Rd Ste 401",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480347661",
            "country_code": "US",
            "telephone_number": "248-294-0539",
            "fax_number": "248-934-1390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENN",
        "first_name": "TYNISE",
        "middle_name": "LA'SHAIE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-03",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704240129",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704240129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYNISE",
            "last_name": "GRAY",
            "middle_name": "LA'SHAIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Isaac Nicholas Peeters, LLPC
• Elizabeth Margery Pelletier, PAC
• Pelvic and Beyond Specialized Physical Therapy
• Angela Eva Pena, LMSW, CBIS
• Emma Katherine Pence
• Allysa Pennington, LLPC
• Travis Andrew Penrod, DPT
• Lashawn Peoples, AASN, CHW
• Agustin Perez Rodriguez, NP
• Iliani Perez Rodriguez, LLMSW

• Adult Health Nurse Practitioner in Lansing, MI
• Providers in Lansing, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.