Individual provider Active NPI

Mary P Sharp, M.D.

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1336188044
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301044837 Issued in MI
Practice address
1703 E Michigan Ave
Lansing, MI 48912-2841
Phone
(517) 913-3860
Fax
(517) 484-6864
NPI assigned
Jun 6, 2006
Last updated
Oct 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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 4301044837 MI Primary

Addresses

Primary practice location

1703 E Michigan Ave
Lansing, MI 48912-2841

Mailing address

1703 E Michigan Ave
Lansing, MI 48912-2841
Phone (517) 913-3860

Other identifiers 10

IdentifierTypeStateIssuer
0803310911OtherMIBCBS/BCN
200000002706OtherMIPHP
1009478OtherMIMCLAREN HEALTH PLAN-COMMERCIAL
0M54770005OtherMIMEDICARE ADVANTAGE
1009478OtherMIMCLAREN HEALTH PLAN-MEDICAID
4482115OtherMIAETNA
110245480OtherMIRAILROAD MEDICARE
1009478OtherMIMCLAREN HEALTH ADVANTAGE
4437261MedicaidMI
200000002706OtherMIPHP FAMILYCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301044837MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Michigan Physicians, PC Family Medicine Past Accepting new patients

Organizations & group practices 1

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1336188044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122841",
            "telephone_number": "517-913-3860",
            "fax_number": "517-484-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122841",
            "telephone_number": "517-913-3860",
            "fax_number": "517-484-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "MARY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301044837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/BCN",
            "identifier": "0803310911",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "200000002706",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN-COMMERCIAL",
            "identifier": "1009478",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ADVANTAGE",
            "identifier": "0M54770005",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN-MEDICAID",
            "identifier": "1009478",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4482115",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110245480",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH ADVANTAGE",
            "identifier": "1009478",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4437261",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP FAMILYCARE",
            "identifier": "200000002706",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.