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Individual provider Active NPI

Bethany Anne Hartrum, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Ludington, MI
National Provider Identifier
1093842759
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704152187 Issued in MI
Practice address
7 Atkinson Dr
Ludington, MI 49431-1953
Phone
(231) 843-3487
NPI assigned
Feb 28, 2007
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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 4704152187 MI Primary

Addresses

Primary practice location

7 Atkinson Dr
Ludington, MI 49431-1953

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bhartrum6573@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121109000626 MI Practitioner - Nurse Practitioner 4688825110 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7 Atkinson Dr
Ludington, MI 49431-1953

922 Lawndale St
Ludington, MI 49431-1928
Phone (231) 845-7380

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center of West Michigan CurrentSince Dec 9, 2019 Accepting new patients
West Michigan Community Mental Health System CurrentSince Feb 11, 2019 Accepting new patients
West Michigan Community Mental Health System CurrentSince Feb 11, 2019 Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

7 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-3487

7 Atkinson Dr
Ste 111
Ludington, MI 49431
Phone (231) 733-2008

920 Diana St
Ludington, MI 49431
Phone (231) 843-7297

Interoperability endpoints

  • Direct secure messaging: bhartrum6573@epic00.corewelldirect.org
  • Direct secure messaging: bhartrum6573@epic00.shdirect.org

Organizations & group practices 4

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 6

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1093842759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 ATKINSON DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-843-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTRUM",
        "first_name": "BETHANY",
        "middle_name": "ANNE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704152187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhartrum6573@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "7 Atkinson Dr",
            "city": "Ludington",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494311953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "7 Atkinson Dr",
            "city": "Ludington",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494311953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.