Active NPI
Jaimie L Fast, ARNP
- Family Nurse Practitioner
- Lansing, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704337446
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145422 | Other | IA | RN LICENSE |
| A156281 | Other | IA | ARNP 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
Enrollment records 1
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
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 100
- Promoting interoperability
- 88
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145422 | IA | MD | Family Nurse Practitioner |
| 4704337446 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audrey Bruell, M.D. P.C. | Current | Accepting new patients | |
| Pinnacle Dermatology, SC | Current | Accepting new patients |
Locations
37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931
3810 Central Pike
Hermitage, TN 37076
Interoperability endpoints
- 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.
-
- Dermatology Physician
- Livonia, MI
- NPI 1306965983
-
- Non-Pharmacy Dispensing Site
- Clarksville, TN
- NPI 1245901941
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.