Individual provider Active NPI

Diana Lynne Leroux, FNP-BC

  • Family Nurse Practitioner
  • Muskegon, MI
National Provider Identifier
1659935716
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704252967 Issued in MI
Practice address
2009 Holton Rd
Muskegon, MI 49445-1578
Phone
(231) 291-8399
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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 4704252967 MI Primary

Addresses

Primary practice location

2009 Holton Rd
Muskegon, MI 49445-1578

Mailing address

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

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
I20210119000579 MI Practitioner - Nurse Practitioner 9133551336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

1670 E Sherman Blvd
Suite 100
Muskegon, MI 49444-1863
Phone (231) 672-3600

2006 Holton Rd
Suite 500
Muskegon, MI 49445-1505
Phone (231) 370-1280

2305 Genoa Bus Park Dr
Brighton, MI 48114-7005

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Care Clinic L.L.C CurrentSince Aug 10, 2019 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Oct 1, 2023 Accepting new patients
Iha Health Services Corporation CurrentSince Oct 1, 2023 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: dleroux2069584@direct.trinity-health.org

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.

Hospital & facility affiliations 1

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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1659935716",
    "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": "2009 HOLTON RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494451578",
            "telephone_number": "231-291-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEROUX",
        "first_name": "DIANA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704252967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.