Individual provider Active NPI

Jaimie L Fast, ARNP

  • Family Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1134742802
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704337446 Issued in MI
Practice address
5135 S Pennsylvania Ave
Lansing, MI 48911-4002
Phone
(517) 220-7546
NPI assigned
May 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 145422 IA
Family Nurse Practitioner 363LF0000X 4704337446 MI Primary

Addresses

Primary practice location

5135 S Pennsylvania Ave
Lansing, MI 48911-4002

Mailing address

3810 Central Pike
Hermitage, TN 37076-3494
Phone (815) 744-8554

Other identifiers 2

IdentifierTypeStateIssuer
145422OtherIARN LICENSE
A156281OtherIAARNP LICENSE

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
I20220927002182 MI Practitioner - Nurse Practitioner 8426472895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

1080 S Van Dyke Rd
Suite 400
Bad Axe, MI 48413-9635
Phone (810) 245-7766

111 Lansing St
Suite 100
Charlotte, MI 48813-2400
Phone (517) 543-5110

2685 Jolly Rd
Okemos, MI 48864-3553
Phone (517) 993-5900

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145422IAMDFamily Nurse Practitioner
4704337446MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Audrey Bruell, M.D. P.C. Current Accepting new patients
Pinnacle Dermatology, SC CurrentSince Nov 20, 2022 Accepting new patients

Locations

37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931

3810 Central Pike
Hermitage, TN 37076

Interoperability endpoints

  • Direct secure messaging: j.fast@iowaderm.emadirect.md

Organizations & group practices 3

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": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1134742802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 CENTRAL PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370763494",
            "telephone_number": "815-744-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 S PENNSYLVANIA AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114002",
            "telephone_number": "517-220-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAST",
        "first_name": "JAIMIE",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "145422",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704337446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "145422",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "A156281",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.