Individual provider Active NPI

Laura Ann Goldman, APRN-BC

  • Family Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1639361876
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704141056 Issued in MI
Practice address
4200 Whitehall Dr
Suite 150
Ann Arbor, MI 48105-9694
Phone
(734) 995-0308
Fax
(734) 995-0425
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 4704141056 MI Primary

Addresses

Primary practice location

4200 Whitehall Dr
Suite 150
Ann Arbor, MI 48105-9694

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 - Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

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
I20090708000347 MI Practitioner - Nurse Practitioner 4183775968 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Eaton Hospital CurrentSince Aug 1, 2017 Accepting new patients
Iha Health Services Corporation CurrentSince Aug 1, 2016 Accepting new patients
Epmg of Michigan, P.C. CurrentSince Sep 15, 2015 Accepting new patients
Livingston County Community Mental Health Authority CurrentSince Nov 21, 2019 Accepting new patients
Sparrow Eaton Hospital CurrentSince Aug 1, 2017 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Aug 1, 2016 Accepting new patients
Bio Energy Medical Center, PC PastSince Nov 16, 2020 Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

4200 Whitehall Dr
Ste 150
Ann Arbor, MI 48105
Phone (734) 995-0308

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

111 Lansing St
Ste 110
Charlotte, MI 48813
Phone (517) 541-5855

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

2280 E Grand River Ave
Howell, MI 48843
Phone (517) 546-4126

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

622 E Grand River Ave
Howell, MI 48843
Phone (517) 548-0081

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Organizations & group practices 8

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1639361876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 - LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WHITEHALL DR",
            "address_2": "SUITE 150",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059694",
            "telephone_number": "734-995-0308",
            "fax_number": "734-995-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704141056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.