Active NPI
Destiny Lewis, RN
- Community Health Registered Nurse
- Ann Arbor, MI
National Provider Identifier
1467767004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- L200139585675
- Practice address
- 2140 Ellsworth
Ann Arbor, MI 48108 - Phone
- (734) 222-3400
- Fax
- (734) 222-3461
- NPI assigned
- Aug 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | L200139585675 | MI | Primary |
Addresses
Primary practice location
2140 Ellsworth
Ann Arbor, MI 48108
Mailing address
P.O. Box 915
555 Towner
Ypsilanti, MI 48197
Phone (734) 544-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L200139585675 | MI | MD | Community Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washtenaw Community Health Organization | Past | Accepting new patients | |
| County of Washtenaw | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Washtenaw county Public Health
- State or Local Public Health Clinic/Center
- Ypsilanti, MI
- NPI 1609896018
-
- Health Maintenance Organization
- Ypsilanti, MI
- NPI 1851467799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281052800000",
"number": "1467767004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 915",
"address_2": "555 TOWNER",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "48197",
"telephone_number": "734-544-3000",
"fax_number": "734-544-6732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 ELLSWORTH",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-222-3400",
"fax_number": "734-222-3461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "DESTINY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-06",
"last_updated": "2010-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "MI",
"license": "L200139585675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.