Lydia Jordan Leonard, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704292824 Issued in MI

Practice address

3190 Northridge Rd
Hale, MI 48739-9276

Phone

(989) 728-6000

Fax

(989) 728-6003

NPI assigned

Jun 20, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD
• Northridge Family Practice LLC

  • Clinical Cardiac Electrophysiology Physician
  • Hale, MI
  • NPI 1780803932
  NPD (past)

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306366562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3190 NORTHRIDGE DRIVE",
            "city": "HALE",
            "state": "MI",
            "postal_code": "48739",
            "telephone_number": "989-728-6000",
            "fax_number": "989-728-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 NORTHRIDGE RD",
            "city": "HALE",
            "state": "MI",
            "postal_code": "487399276",
            "telephone_number": "989-728-6000",
            "fax_number": "989-728-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "LYDIA",
        "middle_name": "JORDAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704292824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "4704292824",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dean Edward Guoan, MSN, FNP-C
• Hale Chiropractic PC
• Hometown Pharmacy Inc (Hometown Pharmacy #39 -Hale)
• Annabelle Kopcan
• Tracy Lynn Landrey, MA COUNSELING
• Shanell Losinski
• Margaret M Marth, NP
• William McCadie, D.O.
• Jordan K McGuire, NP
• McLaren Bay Region

• Family Nurse Practitioner in Hale, MI
• Providers in Hale, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.