Individual provider Active NPI

Laura Courtney Trail, NP

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1548955412
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704315236 Issued in MI
Practice address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Phone
(616) 486-6790
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704315236 MI Primary

Addresses

Primary practice location

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

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
I20230703001173 MI Practitioner - Nurse Practitioner 2466811856 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

5515 Cleveland Ave
Suite 5
Stevensville, MI 49127-9670
Phone (269) 429-9644

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet CurrentSince May 18, 2023 Accepting new patients
Lakeland Medical Practices CurrentSince May 18, 2023 Accepting new patients
Lakeland Medical Practices CurrentSince May 18, 2023 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince May 18, 2023 Accepting new patients
Lakeland Community Hospital Watervliet Current Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince May 18, 2023 Accepting new patients
Lakeland Community Hospital Watervliet Past Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

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

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

5515 Cleveland Ave
Ste 5
Stevensville, MI 49127
Phone (269) 429-9644

460 Medical Park Dr
Ste 200
Watervliet, MI 49098

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

Interoperability endpoints

  • Direct secure messaging: ltrail1272366@epic00.corewelldirect.org
  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Organizations & group practices 7

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": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1548955412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAIL",
        "first_name": "LAURA",
        "middle_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704315236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.