Carolyn Jean Needham, FNP-C
Individual provider Active NPI Nurse Practitioner · Dundee, MI
NPI 1124898291 · NPPES record last updated May 9, 2024
Key facts
- NPI
- 1124898291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704321112 (MI)
- Practice address
- 1234 Plank Rd
Dundee, MI 48131-9750 - Phone
- (419) 344-9156
- NPI assigned
- Jan 8, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Promedica Northwest Ohio Cardiology Consultants LLC
Practice addresses (Care Compare)
2940 N McCord Rd
Toledo, OH 43615-1753
Phone (419) 842-3000
730 N Macomb St
Suite 228
Monroe, MI 48162-3087
Phone (734) 242-7060
Hospital & facility affiliations
- Promedica Toledo Hospital
- Promedica Monroe Regional Hospital
- Promedica Charles and Virginia Hickman Hospital
- Fostoria Community Hospital
- Wood County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240625004226 | MI | Practitioner - Nurse Practitioner | 1052855566 | Reassigns benefits to 1 organization |
| I20240711002140 | OH | Practitioner - Nurse Practitioner | 1052855566 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promedica Northwest Ohio Cardiology Consultants, LLC | Current |
Accepting new patients | |
| Promedica Northwest Ohio Cardiology Consultants, LLC | Current |
Accepting new patients |
Locations
770 Riverside Ave
Ste 106
Adrian, MI 49221
Phone (517) 266-0525
730 N Macomb St
Ste 228
Monroe, MI 48162
Phone (734) 242-7060
730 N Macomb St
Ste 429A
Monroe, MI 48162
1037 Conneaut Ave
Ste 202
Bowling Green, OH 43402
Phone (419) 354-0104
501 Van Buren St
Ste 103
Fostoria, OH 44830
501 Van Buren St
#103
Fostoria, OH 44830
715 S Taft Ave
#1
Fremont, OH 43420
715 S Taft Ave
#195
Fremont, OH 43420
5705 Monclova Rd
Ste 202
Maumee, OH 43537
Phone (419) 891-0136
1600 E Riverview Ave
Napoleon, OH 43545
Phone (260) 344-3045
2751 Bay Park Dr
Ste 305
Oregon, OH 43616
Phone (419) 690-7689
5700 Monroe St
Unit 208
Sylvania, OH 43560
4041 W Central Ave
#204
Toledo, OH 43606
2940 N McCord Rd
Toledo, OH 43615
Phone (419) 842-3000
725 S Shoop Ave
Ste G101
Wauseon, OH 43567
725 S Shoop Ave
#G101
Wauseon, OH 43567
734 S Shoop Ave
#101
Wauseon, OH 43567
Interoperability endpoints
- cneedham172964@direct.promedica.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704321112 | MI | Yes |
Addresses
Primary practice location
1234 Plank Rd
Dundee, MI 48131-9750
Mailing address
1234 Plank Rd
Dundee, MI 48131-9750
Phone (419) 344-9156
Other names
- Carolyn Harnica
Other providers in Dundee, MI
- Michigan Urgent Care
- Monroe Health Ventures, Inc
- Jennifer M Monroe
- Tracy Rene Mueller
- Myeyedr Optometry of Michigan, LLC
- Lynne M Nidek
- Sherry Nolan
- Katelyn Nordyke
- Mary O'Lear
- Angela Michele Parker
All providers in Dundee, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.