Individual provider Active NPI

Laura Leblanc

  • Family Nurse Practitioner
  • Plymouth, MI
National Provider Identifier
1144903964
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704259696 Issued in MI
Practice address
768 York St
Plymouth, MI 48170-1483
Phone
(810) 287-1488
Fax
(734) 462-0344
NPI assigned
Aug 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 4704259696 MI Primary

Addresses

Primary practice location

768 York St
Plymouth, MI 48170-1483

Mailing address

17177 N Laurel Park Dr Ste 439
Livonia, MI 48152-3938
Phone (734) 462-0340

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
I20230814003883 MI Practitioner - Nurse Practitioner 9234591835 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Khalid Rao MD PC CurrentSince Aug 1, 2023 Accepting new patients
Advocates in Home Health Care PC CurrentSince Apr 7, 2025 Accepting new patients
365 Health Care Group PLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

22711 Grand River Ave
Ste 2000
Detroit, MI 48219

100 W Big Beaver Rd
Ste 200
Troy, MI 48084
Phone (248) 552-8195

18500 Van Horn Rd
Woodhaven, MI 48183
Phone (734) 676-7575

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": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1144903964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17177 N LAUREL PARK DR STE 439",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523938",
            "telephone_number": "734-462-0340",
            "fax_number": "734-462-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 YORK ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701483",
            "telephone_number": "810-287-1488",
            "fax_number": "734-462-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704259696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.