NPIMap

Individual provider Active NPI

Wendy Wildern

  • Acute Care Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1164917787
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704250298 Issued in MI
Practice address
1215 E Michigan Ave FL 7
Lansing, MI 48912-1811
Phone
(517) 364-3380
Fax
(517) 364-3399
NPI assigned
Jun 26, 2018
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704250298 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave FL 7
Lansing, MI 48912-1811

Mailing address

PO Box 13008
Lansing, MI 48901-3008
Phone (517) 253-6320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809004946 MI Practitioner - Nurse Practitioner 6800144627 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 E Michigan Ave
Lansing, MI 48912-1811

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Jul 3, 2018 Accepting new patients
Sparrow Clinton Hospital CurrentSince Jul 3, 2018 Accepting new patients
Edward W Sparrow Hospital Association Adult Health CurrentSince Jul 3, 2018 Accepting new patients
Sparrow Clinton Hospital CurrentSince Jul 3, 2018 Accepting new patients
Promed Healthcare CurrentSince Oct 1, 2021 Accepting new patients
Beacon Medical Group Michigan Inc Current Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Jul 3, 2018 Accepting new patients
Sparrow Ionia Hospital CurrentSince Jul 3, 2018 Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Beacon Medical Group Michigan Inc Acute Care CurrentSince Oct 1, 2021 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association PastSince Nov 17, 2019 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1498

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

1200 E Michigan Ave
Ste 530
Lansing, MI 48912
Phone (517) 364-5880

1215 E Michigan Ave
#C
Lansing, MI 48912
Phone (517) 364-2050

1215 E Michigan Ave
Fl 7
Lansing, MI 48912
Phone (517) 364-3380

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1164917787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-253-6320",
            "fax_number": "517-253-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE FL 7",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-3380",
            "fax_number": "517-364-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDERN",
        "first_name": "WENDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704250298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.