Individual provider Active NPI

Lora Rose Hansen, PA

  • Physician Assistant
  • Byron Center, MI
National Provider Identifier
1245630698
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007082 Issued in MI
Practice address
7751 Byron Center Ave SW Ste C
Byron Center, MI 49315-8001
Phone
(616) 267-0357
NPI assigned
Sep 3, 2014
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007082 MI Primary

Addresses

Primary practice location

7751 Byron Center Ave SW Ste C
Byron Center, MI 49315-8001

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
Direct Messaging Address lhansen3672866@epic00.corewelldirect.org

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
I20140918002486 MI Practitioner - Physician Assistant 4587883897 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherry Street Services IncGroup PAC ID 6800707647, 58 clinicians

Practice addresses (Care Compare)

550 Cherry St SE
Grand Rapids, MI 49503-4748
Phone (616) 235-7272

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest M PLLC Physician Assistant CurrentSince Oct 2, 2025 Accepting new patients
Cherry Street Services, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Theoria Medical Physician Assistant CurrentSince Oct 1, 2025 Accepting new patients
Cherry Street Services, Inc CurrentSince Sep 1, 2022 Accepting new patients
Cherry Street Health Services Past Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients

Locations

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

100 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 965-8209

550 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 235-7272

331 Meadows Dr
Grayling, MI 49738
Phone (989) 348-2801

2280 Tower Hill Rd
Houghton Lake, MI 48629
Phone (989) 422-5153

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

Interoperability endpoints

  • Direct secure messaging: lhansen40075@direct.covenanthealthcare.com
  • Direct secure messaging: lora.hansen.p1@direct.cherryhealth.nextgenshare.com

Organizations & group practices 8

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 3

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": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1245630698",
    "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": "7751 BYRON CENTER AVE SW STE C",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158001",
            "telephone_number": "616-267-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "LORA",
        "middle_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "7751 Byron Center Ave SW Ste C",
            "city": "Byron Center",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493158001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lhansen3672866@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "7751 Byron Center Ave SW Ste C",
            "city": "Byron Center",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493158001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

Verify at the official NPI Registry.