Individual provider Active NPI

Lynn Deweese

  • Nurse Practitioner
  • Charlotte, MI
National Provider Identifier
1295284297
Registry record updated Oct 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704188899 Issued in MI
Practice address
4557 Island Hwy
Charlotte, MI 48813-9318
Phone
(517) 242-5918
NPI assigned
Oct 2, 2016
Last updated
Oct 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704188899 MI Primary

Addresses

Primary practice location

4557 Island Hwy
Charlotte, MI 48813-9318

Mailing address

4557 Island Hwy
Charlotte, MI 48813-9318
Phone (517) 242-5918

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
I20161118000259 MI Practitioner - Nurse Practitioner 0446539217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 E Michigan Ave
University of Michigan Health Sparrow Neuro
Lansing, MI 48912-1811
Phone (517) 364-5930

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704188899MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Nov 1, 2016 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Nov 1, 2016 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1200 E Michigan Ave
Ste 340
Lansing, MI 48912
Phone (517) 364-5930

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

Organizations & group practices 4

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 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": "1475366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475366400000",
    "number": "1295284297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4557 ISLAND HWY",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488139318",
            "telephone_number": "517-242-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4557 ISLAND HWY",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488139318",
            "telephone_number": "517-242-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-02",
        "last_updated": "2016-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704188899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, MI

Sources for this page

Verify at the official NPI Registry.