Individual provider Active NPI

Autumn Lindsay, MD, LPN

  • Pediatrics Physician
  • Jackson, MI
National Provider Identifier
1376069682
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301511761 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-5710
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703118320 MI
Licensed Vocational Nurse 164X00000X 4703118320 MI
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 4301511761 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-5710

Other practice location 1

2766 W 11 Mile Rd Ste 2
Berkley, MI 48072-3033
Phone (248) 542-5621

Other practice location 2

2213 Franklin Ave
Toledo, OH 43620-1402
Phone (419) 251-2415

Other practice location 3

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone (248) 436-4365

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
I20240703003372 MI Practitioner - Pediatric Medicine 4880138676 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4703118320MIMDLicensed Vocational Nurse
4301511761MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc Pediatrics CurrentSince Jun 1, 2024 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jun 1, 2024 Accepting new patients
W. a. Foote Memorial Hospital, Inc. Current Accepting new patients
W.a. Foote Memorial Hospital Past Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

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

760 W Franklin St
Jackson, MI 49201
Phone (517) 205-1461

Interoperability endpoints

  • Direct secure messaging: alindsay1016337@direct.hfhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1376069682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2766 W 11 Mile Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Berkley",
            "state": "MI",
            "postal_code": "480723033",
            "country_code": "US",
            "telephone_number": "248-542-5621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2213 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436201402",
            "country_code": "US",
            "telephone_number": "419-251-2415",
            "fax_number": "419-251-2422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27777 Inkster Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483345312",
            "country_code": "US",
            "telephone_number": "248-436-4365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "AUTUMN",
        "credential": "MD, LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703118320",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "MI",
            "license": "4703118320",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301511761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.