Alissa Southway, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704284597 Issued in MI

Practice address

46600 Romeo Plank Rd
Suite #4
Macomb, MI 48044-5741

Phone

(586) 228-5437

NPI assigned

Apr 27, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: asouthway1256982@epic00.shdirect.org
• Direct secure messaging: asouthway1011817@direct.beaumont.edu

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.

• David R Mandy DO, PC

  • Pediatrics Physician
  • Macomb, MI
  • NPI 1619323466
  NPD (past)
• Wellstreet Urgent Care of Michigan

  • Non-Pharmacy Dispensing Site
  • Troy, MI
  • NPI 1649952052
  NPD (past)

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1396190328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45726 PENTWATER DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480444237",
            "telephone_number": "586-382-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46600 ROMEO PLANK RD",
            "address_2": "SUITE #4",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445741",
            "telephone_number": "586-228-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-1043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHWAY",
        "first_name": "ALISSA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704284597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asouthway1011817@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Snyder
• Social Resources Inc.
• Sean P Sorrow, LHAS
• Magdalena Sosnowski, GRNA
• Thomas Laurie Southern Jr., SLPD
• Alaina Rochelle Sparks
• Tatjana Spasenovska
• Jane Speer
• St Clair Shores Obstetrics and Gynecology, PLC
• St John Hospital and Medical Center

• Family Nurse Practitioner in Macomb, MI
• Providers in Macomb, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.