NPIMap

Individual provider Active NPI

Lisa May Wilson, MSN, RN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1386282358
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704313432 Issued in MI
Practice address
563 Landings Blvd
Ann Arbor, MI 48103-2715
Phone
(231) 445-2691
NPI assigned
Dec 20, 2019
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704313432 MI Primary
Registered Nurse 163W00000X 4704313432 MI

Addresses

Primary practice location

563 Landings Blvd
Ann Arbor, MI 48103-2715

Mailing address

2488 Colony Way
Ypsilanti, MI 48197-7446
Phone (231) 445-2691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812002658 MI Practitioner - Nurse Practitioner 4789000423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

205 N E Ave
Jackson, MI 49201-1753
Phone (517) 788-4958

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Family CurrentSince Nov 1, 2021 Accepting new patients
W.a. Foote Memorial Hospital, Inc Acute Care CurrentSince Nov 1, 2021 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Nov 1, 2021 Accepting new patients
W.a. Foote Memorial Hospital, Inc Current Accepting new patients
Henry Ford Health System CurrentSince Nov 1, 2021 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1201 E Michigan Ave
Ste 200
Jackson, MI 49201
Phone (517) 204-4841

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

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: lwilson753880@direct.hfhs.org

Organizations & group practices 7

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 3

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": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1386282358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 COLONY WAY",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481977446",
            "telephone_number": "231-445-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 LANDINGS BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032715",
            "telephone_number": "231-445-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LISA",
        "middle_name": "MAY",
        "credential": "MSN, RN, AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-20",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704313432",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704313432",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.