NPIMap

Organization Active NPI

Pine Hollow Partner LLC

  • Nurse Practitioner
  • East Lansing, MI
National Provider Identifier
1275984700
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PINE HOLLOW PARTNER LLC
Practice address
6200 Pine Hollow Dr
Ste 400
East Lansing, MI 48823-9700
Phone
(517) 339-1676
Fax
(517) 339-2716
NPI assigned
Jun 27, 2016
Last updated
Oct 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Authorized official

Name
Iris Zink, NPNPI 1487729752
Title
Owner/Authorized Official
Phone
(517) 339-1676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

6200 Pine Hollow Dr
Ste 400
East Lansing, MI 48823-9700

Mailing address

6200 Pine Hollow Dr
Ste 400
East Lansing, MI 48823-9700
Phone (517) 339-1676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160930000063 MI Part B Supplier - Clinic/Group Practice 5092002360 Receives reassigned benefits from 7 practitioners
Practice locations: Okemos, MI; East Lansing, MI

National Provider Directory

National Provider Directory

Locations

3945 Okemos Rd
Okemos, MI 48864
Phone (517) 295-5000

3945 Okemos Rd
Ste A2
Okemos, MI 48864
Phone (517) 339-1676

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1275984700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 PINE HOLLOW DR",
            "address_2": "STE 400",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488239700",
            "telephone_number": "517-339-1676",
            "fax_number": "517-339-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 PINE HOLLOW DR",
            "address_2": "STE 400",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488239700",
            "telephone_number": "517-339-1676",
            "fax_number": "517-339-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE HOLLOW PARTNER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "ZINK",
        "authorized_official_first_name": "IRIS",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "517-339-1676",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.