NPIMap

Individual provider Active NPI

Andrea Perry, NP-C

  • Family Nurse Practitioner
  • Eaton Rapids, MI
National Provider Identifier
1407312200
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704300979 Issued in MI
Practice address
1500 S Main St
Eaton Rapids, MI 48827-1952
Phone
(517) 999-4500
Fax
(517) 999-4510
NPI assigned
Feb 16, 2019
Last updated
Apr 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704300979 MI Primary

Addresses

Primary practice location

1500 S Main St
Eaton Rapids, MI 48827-1952

Mailing address

PO Box 266
Eaton Rapids, MI 48827-0266

Other practice location 1

1215 E Michigan Ave
Lansing, MI 48912-1896
Phone (517) 364-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrea.perry@ermc.midirect.net Direct

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
I20190723000348 MI Practitioner - Nurse Practitioner 3971839424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eaton Rapids Medical CenterGroup PAC ID 5991692634, 34 clinicians

Practice addresses (Care Compare)

1500 S Main St
Eaton Rapids, MI 48827-1952

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704300979MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eaton Rapids Medical Center CurrentSince Jul 1, 2019 Accepting new patients
Eaton Rapids Medical Center CurrentSince Jul 1, 2019 Accepting new patients
Eaton Rapids Medical Center Past Accepting new patients
Eaton Rapids Medical Center Past Accepting new patients
McLaren Greater Lansing Nurse Practitioner Past Accepting new patients

Locations

1500 S Main St
Eaton Rapids, MI 48827
Phone (517) 663-2671

1500 S Main St
#C
Eaton Rapids, MI 48827

400 E Main St
#200
Springport, MI 49284
Phone (517) 857-4500

Organizations & group practices 5

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 4

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": "1550275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1407312200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 266",
            "city": "EATON RAPIDS",
            "state": "MI",
            "postal_code": "488270266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "EATON RAPIDS",
            "state": "MI",
            "postal_code": "488271952",
            "telephone_number": "517-999-4500",
            "fax_number": "517-999-4510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121896",
            "country_code": "US",
            "telephone_number": "517-364-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ANDREA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-16",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704300979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrea.perry@ermc.midirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 S Main St",
            "city": "Eaton Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488271952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eaton Rapids, MI

Sources for this page

Verify at the official NPI Registry.