Individual provider Active NPI

Michele Lynn Gargan, NP

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1568567154
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704239149 Issued in MI
Practice address
2664 Georgetown Blvd
Ann Arbor, MI 48105-1554
Phone
(734) 665-2751
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704239149 MI Primary
Adult Health Nurse Practitioner 363LA2200X 4704239149 MI
Community Health Nurse Practitioner 363LC1500X 4704239149 MI
Primary Care Nurse Practitioner 363LP2300X 4704239149 MI

Addresses

Primary practice location

2664 Georgetown Blvd
Ann Arbor, MI 48105-1554

Mailing address

2664 Georgetown Blvd
Ann Arbor, MI 48105-1554
Phone (734) 548-4352

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
I20050826000651 MI Practitioner - Nurse Practitioner 7416988662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of WashtenawGroup PAC ID 9931161585, 18 clinicians

Practice addresses (Care Compare)

110 N 4TH Ave
Washtenaw County Community Mental Health
Ann Arbor, MI 48104-5503
Phone (734) 544-3050

555 Towner St
Ypsilanti, MI 48198-5723
Phone (734) 544-3050

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1568567154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2664 GEORGETOWN BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051554",
            "telephone_number": "734-548-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2664 GEORGETOWN BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051554",
            "telephone_number": "734-665-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARGAN",
        "first_name": "MICHELE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704239149",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704239149",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MI",
            "license": "4704239149",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704239149",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.