Individual provider Active NPI

Tammy Fletcher, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pontiac, MI
National Provider Identifier
1104223544
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704213030 Issued in MI
Practice address
1841 N Perry
Pontiac, MI 48340
Phone
(248) 377-2673
NPI assigned
Dec 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704213030 MI
Registered Nurse 163W00000X L2394237 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704213030 MI Primary

Addresses

Primary practice location

1841 N Perry
Pontiac, MI 48340

Mailing address

38855 Hills Tech Dr
Suite 200
Farmington Hills, MI 48331
Phone (248) 871-1495

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
I20200827001602 MI Practitioner - Nurse Practitioner 6800213497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1225 E Big Beaver Rd
Troy, MI 48083-1905
Phone (248) 524-8801

929 Stevens St
Flint, MI 48502-1620
Phone (810) 232-6081

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704213030MIMDRegistered Nurse
L2394237MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Training and Treatment Innovations Inc CurrentSince Apr 8, 2021 Accepting new patients
Training & Treatment Innovations Inc CurrentSince Apr 8, 2021 Accepting new patients

Locations

929 Stevens St
Flint, MI 48502
Phone (810) 232-6081

1450 S Lapeer Rd
Oxford, MI 48371
Phone (248) 969-9932

3665 Bay Rd
Saginaw, MI 48603
Phone (989) 799-0066

13213 E 14 Mile Rd
Sterling Heights, MI 48312
Phone (586) 939-4374

1225 E Big Beaver Rd
Troy, MI 48083
Phone (248) 524-8801

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1104223544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38855 HILLS TECH DR",
            "address_2": "SUITE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48331",
            "telephone_number": "248-871-1495",
            "fax_number": "248-994-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 N PERRY",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48340",
            "telephone_number": "248-377-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "TAMMY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704213030",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "L2394237",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704213030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.