Individual provider Active NPI

Lana K Bretz, NP

  • Nurse Practitioner
  • Portage, MI
National Provider Identifier
1336663053
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704293707 Issued in MI
Practice address
2725 Airview Blvd Ste 105
Portage, MI 49002-1804
Phone
(269) 349-8386
Fax
(269) 349-8397
NPI assigned
Aug 3, 2017
Last updated
Aug 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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 4704293707 MI Primary

Addresses

Primary practice location

2725 Airview Blvd Ste 105
Portage, MI 49002-1804

Mailing address

2725 Airview Blvd Ste 105
Portage, MI 49002-1804
Phone (269) 349-8386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210121000728 TX Practitioner - Nurse Practitioner 5597037432 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704293707MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Apr 2, 2024 Accepting new patients

Organizations & group practices 2

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": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1336663053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 AIRVIEW BLVD STE 105",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021804",
            "telephone_number": "269-349-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 AIRVIEW BLVD STE 105",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021804",
            "telephone_number": "269-349-8386",
            "fax_number": "269-349-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETZ",
        "first_name": "LANA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704293707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.