Elise Shannon Peaney Wildern, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704292079 Issued in MI

Practice address

3404 Patient Care Dr
Lansing, MI 48911-4217

Phone

(517) 267-0200

NPI assigned

Mar 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Michigan Orthopedic Center P C

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Lansing, MI
  • NPI 1326371964

  MI

  Medicare reassignment Care Compare group NPD
• Sparrow Eaton Hospital

  • Orthopaedic Surgery Physician
  • Charlotte, MI
  • NPI 1043419427

  MI

  Medicare reassignment NPD
• Sparrow Eaton Hospital

  • Critical Access Hospital
  • Charlotte, MI
  • NPI 1942254529

  MI

  Medicare reassignment
• Sparrow Eaton Hospital

  • School Nurse Practitioner
  • East Lansing, MI
  • NPI 1063227486
  NPD
• Sparrow Eaton Hospital

  • Family Medicine Physician
  • Charlotte, MI
  • NPI 1225237613
  NPD
• Charles J Taunt Jr DO PC

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Lansing, MI
  • NPI 1588739395
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711

  Hospital

  Care Compare affiliation
• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719

  Hospital

  Care Compare affiliation
• McLaren Greater Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1134104672

  Hospital

  Care Compare affiliation
• Sparrow Clinton Hospital

  • Critical Access Hospital
  • Saint Johns, MI
  • NPI 1093809824

  Hospital

  Care Compare affiliation
• Sparrow Eaton Hospital

  • Orthopaedic Surgery Physician
  • Charlotte, MI
  • NPI 1043419427

  Hospital

  Care Compare affiliation
• Sparrow Eaton Hospital

  • Ambulance
  • Charlotte, MI
  • NPI 1093742249

  Hospital

  Care Compare affiliation
• Sparrow Eaton Hospital

  • Critical Access Hospital
  • Charlotte, MI
  • NPI 1942254529

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Orthopedic Center P C 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
• University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327
• University of Michigan Health- Sparrow Clinton Hospital, Saint Johns, MI, CCN 231326

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1376138644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 CANTERBURY DR",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131038",
            "telephone_number": "517-896-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 PATIENT CARE DR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114217",
            "telephone_number": "517-267-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDERN",
        "first_name": "ELISE",
        "middle_name": "SHANNON PEANEY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704292079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Lynn Wilbert
• Marysa Wilburn
• Wilcox Wellness
• Mario Wilcox, LMSW
• Matthew D Wilcox, DO
• Wendy Wildern
• Sharon K. Wilkes, LMSW
• Katie Lee Wilkins, PT
• Stephanie Wilkinson
• Kisha Wilks-Foreman

• All providers in Lansing, MI
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.