Lisa Sonia Maclellan, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704242836 Issued in MI

Practice address

3250 Woods Way Ste 5
Petoskey, MI 49770-7628

Phone

(231) 881-9700

Fax

(231) 881-9698

NPI assigned

Jun 10, 2019

Last updated

Aug 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105
• Chippewa County War Memorial Hospital Hospital, Sault Ste Marie, MI, CCN 230239

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14008/brand/2/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/23627/brand/1/csg/1/fhir/r4
• Direct secure messaging: lmaclellan@pspc.gwaydirect.com

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.

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Complexcare Medical Group Midwest M PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1528851607

  Nurse Practitioner

  Medicare reassignment NPD
• Integrative Cardiovascular Health & Wellness

  dba 4 Seasons Health

  • Public Health & General Preventive Medicine Physician
  • Petoskey, MI
  • NPI 1043676661
  Medicare reassignment NPD
• Petoskey Surgeons, P.C.

  • Surgery Physician
  • Petoskey, MI
  • NPI 1730145574
  Medicare reassignment NPD
• Brain and Spine Associates PC

  • Neurological Surgery Physician
  • Bay City, MI
  • NPI 1710651195
  NPD
• Alpine Cardiology, PLLC

  • Cardiovascular Disease Physician
  • Gaylord, MI
  • NPI 1265803316
  NPD (past)
• Wellbridge of Clarkston, LLC

  • Skilled Nursing Facility
  • Independence Township, MI
  • NPI 1669965299
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLaren Northern Michigan

  • Psychiatric Hospital Unit
  • Cheboygan, MI
  • NPI 1336897735
  Care Compare affiliation
• McLaren Northern Michigan

  • General Acute Care Hospital
  • Petoskey, MI
  • NPI 1992812580
  Care Compare affiliation
• Mymichigan Medical Center Sault

  dba Chippewa County War Memorial Hospital, Inc

  • General Acute Care Hospital
  • Sault Sainte Marie, MI
  • NPI 1295756948
  Care Compare affiliation

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1629637921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 W BEEMAN RD",
            "city": "EMPIRE",
            "state": "MI",
            "postal_code": "496309739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 WOODS WAY STE 5",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497707628",
            "telephone_number": "231-881-9700",
            "fax_number": "231-881-9698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 W Beeman Rd",
            "address_purpose": "LOCATION",
            "city": "Empire",
            "state": "MI",
            "postal_code": "496309739",
            "country_code": "US",
            "telephone_number": "561-275-9798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACLELLAN",
        "first_name": "LISA",
        "middle_name": "SONIA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704242836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna B. Lund, N.P.
• Claudia Ann Lutosky, PH.D.
• Nancy Lynn Lyons, M.S. CCC/SLP
• M. Elizabeth Swenor, DO, PC
• Shanna Macclaren, FNP-C
• Elizabeth Madell, LMT
• Elizabeth Barron Madison, MD, MA
• Jill Magrum, MA, CAADC-D
• Mallory Hallett Mahoney, ND, RAC
• Aubrey Jo Major

• Nurse Practitioner in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.