Individual provider Active NPI

Lisa L Legere-Struntz, D.O.

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1316970312
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013022 Issued in MI
Practice address
400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6125
Phone
(517) 784-0588
Fax
(517) 784-3866
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101013022 MI Primary

Addresses

Primary practice location

400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6125

Mailing address

PO Box 67000
Department 272801
Detroit, MI 48267-0002
Phone (517) 841-6913

Other identifiers 5

IdentifierTypeStateIssuer
080084532OtherMIRAILROAD MEDICARE
0853800375OtherMIBLUE CROSS BLUE SHIELD
1678894OtherCIGNA HEALTHCARE
115188133MedicaidMI
3257661MedicaidMI

Other names 1

  • Lisa L Legere Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address llegerestruntz456356@direct.hfhs.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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070712000161 MI Practitioner - Family Practice 0749380376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 Hinckley Blvd
Suite 100
Jackson, MI 49203-6152
Phone (517) 205-8991

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101013022MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jul 1, 2007 Accepting new patients
Wa Foote Memorial Hospital, Inc Family Medicine CurrentSince Jul 1, 2007 Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

27931 C Dr N
Albion, MI 49224
Phone (517) 629-8311

400 Hinckley Blvd
Ste 100
Jackson, MI 49203
Phone (517) 205-8991

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

400 Hinckley Blvd
Jackson, MI 49203
Phone (517) 205-2299

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

Interoperability endpoints

  • Direct secure messaging: llegerestruntz456356@direct.hfhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1316970312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPARTMENT 272801",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670002",
            "telephone_number": "517-841-6913",
            "fax_number": "517-841-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HINCKLEY BLVD",
            "address_2": "SUITE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492036125",
            "telephone_number": "517-784-0588",
            "fax_number": "517-784-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGERE-STRUNTZ",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080084532",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0853800375",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "1678894",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115188133",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3257661",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llegerestruntz456356@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "400 Hinckley Blvd",
            "address_2": "Suite 100",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492036125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LEGERE",
            "middle_name": "L",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.