Individual provider Active NPI

Nicholas James Lannen, M.D.

  • Neurology Physician
  • Grand Rapids, MI
National Provider Identifier
1619358686
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301502075 Issued in MI
Practice address
2750 E Beltline Ave NE FL 3
Grand Rapids, MI 49525-8614
Phone
(616) 267-7104
NPI assigned
Jun 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301502075 MI Primary

Addresses

Primary practice location

2750 E Beltline Ave NE FL 3
Grand Rapids, MI 49525-8614

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nlannen112164@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190618002649 VA Practitioner - Neurology 8527372606 Reassigns benefits to 1 organization
I20200813000453 MI Practitioner - Neurology 8527372606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Wayne State University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone (616) 267-8700

2750 E Beltline Ave NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-8614
Phone (616) 267-8950

2750 E Beltline Ave NE FL
Grand Rapids, MI 49525-8614

2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone (616) 267-8860

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Corewell Health Big Rapids Hospital Hospital, Big Rapids, MI, CCN 230093
  • Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035
  • Corewell Health Ludington Hospital Hospital, Ludington, MI, CCN 230110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jul 1, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 27, 2020 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 27, 2020 Accepting new patients

Locations

25 Michigan St NE
Ste 6100
Grand Rapids, MI 49503
Phone (616) 267-7900

2750 E Beltline Ave NE
Fl 3
Grand Rapids, MI 49525
Phone (616) 447-5820

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

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1221 Lee St
Charlottesville, VA 22908

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: nlannen112164@epic00.corewelldirect.org
  • Direct secure messaging: nlannen112164@epic00.shdirect.org

Organizations & group practices 3

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 6

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1619358686",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 E BELTLINE AVE NE FL 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495258614",
            "telephone_number": "616-267-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANNEN",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301502075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nlannen112164@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "2750 E Beltline Ave NE Fl 3",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495258614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2750 E Beltline Ave NE Fl 3",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495258614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.