Individual provider Active NPI

Lauren Bennett

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1629430509
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704270449 Issued in MI
Practice address
4100 John R St
Detroit, MI 48201-2013
Phone
(313) 576-8529
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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 4704270449 MI Primary

Addresses

Primary practice location

4100 John R St
Detroit, MI 48201-2013

Mailing address

4100 John R St
Detroit, MI 48201-2013

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
I20160929000996 MI Practitioner - Nurse Practitioner 8729375035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Ann Karmanos Cancer Institute CurrentSince Jan 1, 2025 Accepting new patients
Barbara Ann Karmanos Cancer Institute CurrentSince Jan 1, 2025 Accepting new patients
University Physician Group Past Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

31995 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 538-4701

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1629430509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "313-576-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704270449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.