NPIMap

Individual provider Active NPI

Leah Anne Eytcheson, CNP

  • Family Nurse Practitioner
  • Greenville, MI
National Provider Identifier
1194297077
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704319027 Issued in MI
Practice address
615 S Bower St
Greenville, MI 48838-2614
Phone
(616) 391-3139
NPI assigned
Dec 17, 2018
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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 4704319027 MI Primary

Addresses

Primary practice location

615 S Bower St
Greenville, MI 48838-2614

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other names 1

  • Leah Anne Carpenter Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lcarpenter177849@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
I20190108002332 MI Practitioner - Nurse Practitioner 1456697796 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)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

615 S Bower St
Greenville, MI 48838-2614
Phone (616) 225-6522

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group Nurse Practitioner CurrentSince Jan 2, 2019 Accepting new patients
Spectrum Health United CurrentSince May 1, 2020 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Spectrum Health United CurrentSince May 1, 2020 Accepting new patients
Pennock Hospital Nurse Practitioner CurrentSince Oct 1, 2020 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 19, 2019 Accepting new patients
Pennock Hospital CurrentSince Oct 1, 2020 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 19, 2019 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Jan 2, 2019 Accepting new patients
Spectrum Health United Past Accepting new patients

Locations

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

2776 S State Rd
Ionia, MI 48846
Phone (616) 267-8700

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

8650 Howard City Edmore Rd
Lakeview, MI 48850
Phone (989) 352-1800

Interoperability endpoints

  • Direct secure messaging: lcarpenter177849@epic00.corewelldirect.org
  • Direct secure messaging: lcarpenter177849@epic00.shdirect.org

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1194297077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S BOWER ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382614",
            "telephone_number": "616-391-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYTCHESON",
        "first_name": "LEAH",
        "middle_name": "ANNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704319027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcarpenter177849@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "615 S Bower St",
            "city": "Greenville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488382614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "615 S Bower St",
            "city": "Greenville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488382614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "CARPENTER",
            "middle_name": "ANNE",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, MI

Sources for this page

Verify at the official NPI Registry.