Individual provider Active NPI

Patience Mpulubusi Nyambe, FNP BC

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1114708294
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704283933 Issued in MI
Practice address
5838 Metro Way SW
Grand Rapids, MI 49519-9619
Phone
(616) 249-5300
NPI assigned
Oct 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 4704283933 MI Primary

Addresses

Primary practice location

5838 Metro Way SW
Grand Rapids, MI 49519-9619

Mailing address

5838 Metro Way SW
Grand Rapids, MI 49519-9619
Phone (616) 249-5300

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
I20231214001605 MI Practitioner - Nurse Practitioner 9739538802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

1471 E Beltline Ave NE
Suite 202
Grand Rapids, MI 49525-4548
Phone (616) 410-7701

2305 Genoa Bus Park Dr
Brighton, MI 48114-7005

3380 44TH St SW
Suite 100 Trinity Health Urgent Care Rivert
Grandville, MI 49418-2461
Phone (616) 410-7703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704283933MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Dec 11, 2023 Accepting new patients
Iha Health Services Corporation CurrentSince Dec 11, 2023 Accepting new patients
Battle Creek Vamc CurrentSince Oct 6, 2024 Accepting new patients
Iha Health Services Corporation Current Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

5838 Metro Way SW
Wyoming, MI 49519
Phone (616) 249-5300

Interoperability endpoints

  • Direct secure messaging: pnyambe293564@direct.trinity-health.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1114708294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5838 METRO WAY SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495199619",
            "telephone_number": "616-249-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5838 METRO WAY SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495199619",
            "telephone_number": "616-249-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAMBE",
        "first_name": "PATIENCE",
        "middle_name": "MPULUBUSI",
        "name_prefix": "Dr.",
        "credential": "FNP BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-13",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704283933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.