Individual provider Active NPI

Lindsay Blair Hargis, CPNP

  • Pediatric Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1538821046
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704315183 Issued in MI
Practice address
3901 Beaubien St
Detroit, MI 48201-2196
Phone
(313) 745-5437
NPI assigned
Oct 12, 2021
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704315183 MI Primary

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2196

Mailing address

21237 Bayside St
Saint Clair Shores, MI 48081-1198
Phone (586) 438-0172

Other practice location 1

44201 Dequindre Rd Ste Ec
Troy, MI 48085-1117
Phone (248) 259-3088

Other practice location 2

44199 Dequindre Rd Ste 502
Troy, MI 48085-1128
Phone (248) 964-5880

Other names 1

  • Lindsay Blair Holdway Former name

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
I20211119002440 MI Practitioner - Nurse Practitioner 1355730920 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians CurrentSince Oct 1, 2021 Accepting new patients
University Pediatricians CurrentSince Oct 1, 2021 Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3901 Beaubien St
Ste H
Detroit, MI 48201
Phone (313) 745-5437

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1538821046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21237 BAYSIDE ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811198",
            "telephone_number": "586-438-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012196",
            "telephone_number": "313-745-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd Ste Ec",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-259-3088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44199 Dequindre Rd Ste 502",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-964-5880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARGIS",
        "first_name": "LINDSAY",
        "middle_name": "BLAIR",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704315183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "HOLDWAY",
            "middle_name": "BLAIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.