Individual provider Active NPI

Ronald Parker, NURSE PRACTITIONER

  • Nurse Practitioner
  • Monroe, MI
National Provider Identifier
1356169908
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704315501 Issued in MI
Practice address
1066 N Monroe St
Monroe, MI 48162-3113
Phone
(734) 240-4870
Fax
(734) 682-5083
NPI assigned
Oct 2, 2024
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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 4704315501 MI Primary

Addresses

Primary practice location

1066 N Monroe St
Monroe, MI 48162-3113

Mailing address

114 N Maumee St
Tecumseh, MI 49286-1529
Phone (517) 260-3409

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
I20250203000741 MI Practitioner - Nurse Practitioner 7517496771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Monroe PhysiciansGroup PAC ID 2365696176, 64 clinicians

Practice addresses (Care Compare)

718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8987

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704315501MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Monroe Physicians CurrentSince Jan 1, 2025 Accepting new patients

Locations

3175 Smith Rd
Lambertville, MI 48144
Phone (734) 856-5494

1066 N Monroe St
Monroe, MI 48162
Phone (734) 240-4870

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

Interoperability endpoints

  • Direct secure messaging: rparker113800@direct.promedica.org

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.

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": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1356169908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N MAUMEE ST",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861529",
            "telephone_number": "517-260-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623113",
            "telephone_number": "734-240-4870",
            "fax_number": "734-682-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "RONALD",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704315501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.