Lenise Anne Banse, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301047653 Issued in MI

Practice address

42452 Hayes Rd
Suite 3
Clinton Township, MI 48038-6771

Phone

(586) 263-3130

Fax

(586) 263-5183

NPI assigned

Jan 23, 2007

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

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: lenise.banse@forefrontdermatology.emadirect.md

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1427102466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-7190",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42452 HAYES RD",
            "address_2": "SUITE 3",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386771",
            "telephone_number": "586-263-3130",
            "fax_number": "586-263-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSE",
        "first_name": "LENISE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301047653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lenise.Banse@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "42452 Hayes Rd",
            "address_2": "Suite 3",
            "city": "Clinton Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480386771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lewis Kenneth Baker III
• Patricia Ballard, MA, LLPC
• Christina Ban, LLMSW
• Joanna Wiktoria Banasik, RN
• Julia Rachel Bank, DO
• Jessica Baranski
• Michelle Barbat
• Amber Barber, LLPC
• Alexia Denine Barbour, BHS SST
• Christina Bardy

• Dermatology Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.