Individual provider Active NPI

Sara Marie Lampman, NP-BC

  • Family Nurse Practitioner
  • Clinton Township, MI
National Provider Identifier
1578345302
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704356754 Issued in MI
Practice address
43900 Garfield Rd Ste 100
Clinton Township, MI 48038-1137
Phone
(586) 286-0112
NPI assigned
Oct 17, 2023
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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 4704356754 MI Primary

Addresses

Primary practice location

43900 Garfield Rd Ste 100
Clinton Township, MI 48038-1137

Mailing address

529 Jacob Way Apt 205
Rochester, MI 48307-6622
Phone (586) 246-0307

Other names 1

  • Miss Sara Marie Funk 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
I20240104002523 MI Practitioner - Nurse Practitioner 0547611444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Center for Dermatology and Pathology PLLCGroup PAC ID 0446330492, 49 clinicians

Practice addresses (Care Compare)

11900 E 12 Mile Rd
Suite 201
Warren, MI 48093-3490
Phone (586) 574-2800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704356754MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Center for Dermatology & Pathology, PLLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

43900 Garfield Rd
Ste 100
Clinton Twp, MI 48038
Phone (586) 286-0112

43900 Garfield Rd
Ste 121
Clinton Twp, MI 48038
Phone (586) 228-3880

11900 E 12 Mile Rd
Ste 201
Warren, MI 48093
Phone (313) 574-2803

Interoperability endpoints

  • Direct secure messaging: sfunk@mwcd.emadirect.md

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, 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": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1578345302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 JACOB WAY APT 205",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483076622",
            "telephone_number": "586-246-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD STE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381137",
            "telephone_number": "586-286-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMPMAN",
        "first_name": "SARA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-17",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704356754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "FUNK",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.