NPIMap

Individual provider Active NPI

Audrey Lynn Wedde, D.O.

  • Family Medicine Physician
  • Buchanan, MI
National Provider Identifier
1457743486
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101021544 Issued in MI
Practice address
1045 E Front St
Buchanan, MI 49107
Phone
(269) 695-5540
Fax
(269) 695-0412
NPI assigned
Feb 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101021544 MI Primary

Addresses

Primary practice location

1045 E Front St
Buchanan, MI 49107

Mailing address

1045 E Front St
Buchanan, MI 49107-8474
Phone (269) 695-5540

Other practice location 1

1234 Napier Ave
Graduate Medical Education
Saint Joseph, MI 49085-2112
Phone (800) 968-0115

Other names 1

  • Audrey Lynn Carrier Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EPIC 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
I20180815002403 MI Practitioner - Family Practice 9830409978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Medical Practices 286 clinicians
Lakeland Community Hospital Watervliet 66 clinicians

Practice addresses (Care Compare)

1045 E Front St
Suite a
Buchanan, MI 49107-8474
Phone (269) 695-5540

2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200

Hospital & facility affiliations

  • Corewell Health Lakeland Hospitals St Joseph Hospital Home health agency, Benton Harbor, MI, CCN 237163
  • Michiana Home Care Home health agency, Niles, MI, CCN 239228
  • Elara Caring Home health agency, Niles, MI, CCN 239005
  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Jul 18, 2018 Accepting new patients
Lakeland Medical Practices CurrentSince Jul 18, 2018 Accepting new patients

Locations

1045 E Front St
Ste A
Buchanan, MI 49107
Phone (269) 695-5540

1045 E Front St
Buchanan, MI 49107
Phone (269) 695-5540

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: awedde1272574@epic00.corewelldirect.org

Organizations & group practices 9

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.

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": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1457743486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 E FRONT ST",
            "city": "BUCHANAN",
            "state": "MI",
            "postal_code": "491078474",
            "telephone_number": "269-695-5540",
            "fax_number": "269-695-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 E FRONT ST",
            "city": "BUCHANAN",
            "state": "MI",
            "postal_code": "49107",
            "telephone_number": "269-695-5540",
            "fax_number": "269-695-0412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 Napier Ave",
            "address_2": "Graduate Medical Education",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490852112",
            "country_code": "US",
            "telephone_number": "800-968-0115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEDDE",
        "first_name": "AUDREY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101021544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1045 E Front St",
            "city": "Buchanan",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "CARRIER",
            "middle_name": "LYNN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buchanan, MI

Sources for this page

Verify at the official NPI Registry.