Individual provider Active NPI

Lauren Ashley Nickerson, NP-C

  • Registered Nurse
  • Lake Ann, MI
National Provider Identifier
1467113399
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704275084 Issued in MI
Practice address
6152 Bellows Lake Rd
Lake Ann, MI 49650-9713
Phone
(313) 590-2631
NPI assigned
Jan 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704275084 MI Primary

Addresses

Primary practice location

6152 Bellows Lake Rd
Lake Ann, MI 49650-9713

Mailing address

302 Hobart St
Cadillac, MI 49601-2379
Phone (231) 876-2644

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lauren@integralhealthandeducation.org Direct

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
I20220309001960 MI Practitioner - Nurse Practitioner 3577958586 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interlochen Emergency Group PCGroup PAC ID 3577918606, 49 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704275084MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ih Physician Services, PC CurrentSince Jul 28, 2025 Accepting new patients
Munson Healthcare Cadillac Current Accepting new patients
Munson Healthcare Cadillac CurrentSince May 1, 2022 Accepting new patients
Caberfae Emergency Group, P.C. CurrentSince Nov 1, 2023 Accepting new patients
Ih Physician Services PC CurrentSince Jul 28, 2025 Accepting new patients
Hawk Emergency Group, P.C. CurrentSince Dec 12, 2023 Accepting new patients
Interlochen Emergency Group, P.C. CurrentSince Nov 1, 2024 Accepting new patients
Munson Healthcare Cadillac CurrentSince May 1, 2022 Accepting new patients

Locations

3782 Momentum Pl
Chicago, IL 60689

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

302 Hobart St
Cadillac, MI 49601
Phone (231) 876-2644

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

224 Park Ave
Frankfort, MI 49635
Phone (231) 352-2200

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

695 Kenmoor Ave SE
Ste B1
Grand Rapids, MI 49546
Phone (616) 438-9902

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

1465 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1000

26211 Central Park Blvd
Ste 600
Southfield, MI 48076
Phone (248) 936-2075

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

4000 Eastern Sky Dr
Ste 2A
Traverse City, MI 49684
Phone (231) 715-3241

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

Organizations & group practices 8

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 1

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1467113399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 HOBART ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012379",
            "telephone_number": "231-876-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6152 BELLOWS LAKE RD",
            "city": "LAKE ANN",
            "state": "MI",
            "postal_code": "496509713",
            "telephone_number": "313-590-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "LAUREN",
        "middle_name": "ASHLEY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704275084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lauren@integralhealthandeducation.org",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "business email",
            "address_1": "6152 Bellows Lake Rd",
            "city": "Lake Ann",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496509713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Ann, MI

Sources for this page

Verify at the official NPI Registry.