Individual provider Active NPI

Jeffrey Rayner Lapennas, NP

  • Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1265114227
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704394815 Issued in MI
Practice address
19100 W 7 Mile Rd
Detroit, MI 48219-2758
Phone
(313) 533-5002
NPI assigned
Aug 1, 2023
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704394815 MI Primary
Nurse Practitioner 363L00000X APRN.CNP.0039414 OH

Addresses

Primary practice location

19100 W 7 Mile Rd
Detroit, MI 48219-2758

Mailing address

1050 Forrer Blvd Ste 250
Kettering, OH 45420-3640
Phone (800) 986-4801

Other practice location 1

1050 Forrer Blvd Ste 250
Kettering, OH 45420-3640
Phone (800) 986-4801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230919003824 MI Practitioner - Nurse Practitioner 0244694578 Reassigns benefits to 2 organizations
I20250918002146 OH Practitioner - Nurse Practitioner 0244694578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illumia Health LLCGroup PAC ID 7810424306, 33 clinicians
Exceptional Care Services LLCGroup PAC ID 5799175741, 36 clinicians

Practice addresses (Care Compare)

Dayton, OH 45459
Phone (937) 910-4004

1302 Millville Ave
Hamilton, OH 45013-3961
Phone (513) 867-4100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Exceptional Care Services LLC Nurse Practitioner CurrentSince Mar 1, 2026 Accepting new patients
Ih Physician Services PC CurrentSince Jan 6, 2025 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Jul 31, 2023 Accepting new patients
Illumia Health LLC CurrentSince May 25, 2025 Accepting new patients
Ih Physician Services, PC CurrentSince Jan 6, 2025 Accepting new patients
Illumia Health LLC CurrentSince Jul 21, 2025 Accepting new patients
Illumia Health LLC CurrentSince Jul 21, 2025 Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients
Ih Physician Services PC Past Accepting new patients

Locations

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

39425 Garfield Rd
Ste 22A
Clinton Township, MI 48038
Phone (586) 649-3181

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

1320 Waldo Ave
Ste 300
Midland, MI 48642
Phone (586) 649-3181

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

25925 Telegraph Rd
Ste 102A
Southfield, MI 48033
Phone (248) 809-1442

26211 Central Park Blvd
Ste 600
Southfield, MI 48076
Phone (248) 936-2075

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

4040 Embassy Pkwy
Ste 410
Akron, OH 44333
Phone (330) 576-5405

7887 Washington Village Dr
Ste 265
Dayton, OH 45459

1302 Millville Ave
Hamilton, OH 45013
Phone (513) 867-4100

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1265114227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 FORRER BLVD STE 250",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454203640",
            "telephone_number": "800-986-4801",
            "fax_number": "937-684-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19100 W 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482192758",
            "telephone_number": "313-533-5002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Forrer Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454203640",
            "country_code": "US",
            "telephone_number": "800-986-4801",
            "fax_number": "937-684-9990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAPENNAS",
        "first_name": "JEFFREY",
        "middle_name": "RAYNER",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-01",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704394815",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0039414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.