Individual provider Active NPI

Dana Marie Wenner, N.P.

  • Adult Health Nurse Practitioner
  • Clinton Township, MI
National Provider Identifier
1114253267
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704234590 Issued in MI
Practice address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone
(586) 263-2788
Fax
(586) 263-2577
NPI assigned
Oct 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704234590 MI Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Mailing address

18020 Eider Drive
Clinton Township, MI 48038
Phone (586) 215-2370

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
I20150318000250 MI Practitioner - Nurse Practitioner 0446577175 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Oakland College of Medicine and Surgery, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of Michigan, P.C.Group PAC ID 1052380219, 10 clinicians

Practice addresses (Care Compare)

18303 E 10 Mile Rd
Suite 100
Roseville, MI 48066-4989
Phone (586) 776-8877

Hospital & facility affiliations

  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704234590MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Ancillary Services Current Accepting new patients
Internal Medicine Associates of Mt. Clemens, PC Current Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients
Cardiovascular Institute of Michigan, P.C. CurrentSince Oct 1, 2015 Accepting new patients
Alliance Health Professionals, PLLC CurrentSince Jun 15, 2016 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Feb 1, 2015 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Feb 1, 2015 Accepting new patients
Preventive Cardiovascular Institute PLLC Past Accepting new patients

Locations

2689 Solution Ctr
Chicago, IL 60677

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

43230 Garfield Rd
Ste 150
Clinton Twp, MI 48038
Phone (586) 412-7251

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880

18303 E 10 Mile Rd
Ste 100
Roseville, MI 48066
Phone (586) 776-8877

Interoperability endpoints

  • Direct secure messaging: dwenner3518@direct.hfhs.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1114253267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18020 EIDER DRIVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "48038",
            "telephone_number": "586-215-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2788",
            "fax_number": "586-263-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNER",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704234590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.