Individual provider Active NPI

Laura Fick, NP

  • Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1407323355
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704202468 Issued in MI
Practice address
744 W Michigan Ave Ste 300
Jackson, MI 49201-1900
Phone
(517) 768-0600
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704202468 MI Primary

Addresses

Primary practice location

744 W Michigan Ave Ste 300
Jackson, MI 49201-1900

Mailing address

744 W Michigan Ave Ste 300
Jackson, MI 49201-1900
Phone (517) 768-0600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190603000422 MI Practitioner - Nurse Practitioner 0547593824 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Family Medicine and Urgent Care CurrentSince Apr 1, 2019 Accepting new patients

Locations

6531 W Michigan Ave
#C
Jackson, MI 49201
Phone (517) 750-3822

6531 W Michigan Ave
Jackson, MI 49201
Phone (517) 750-3822

Organizations & group practices 1

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": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1407323355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE STE 300",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011900",
            "telephone_number": "517-768-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE STE 300",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011900",
            "telephone_number": "517-768-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICK",
        "first_name": "LAURA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704202468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.