Lisa Diane Rinke, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704147850 Issued in MI

Practice address

17120 Kercheval Ave
Grosse Pointe, MI 48230-1661

Phone

(318) 886-3300

NPI assigned

Dec 5, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Lisa Diane Surovick Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment NPD
• Waypointe Internal Medicine, P.C.

  • Internal Medicine Physician
  • St Clair Shores, MI
  • NPI 1649240516
  NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906
  NPD
• Wellstreet Urgent Care of Michigan

  • Non-Pharmacy Dispensing Site
  • Troy, MI
  • NPI 1649952052
  NPD (past)

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1689072738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17120 KERCHEVAL AVE",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301661",
            "telephone_number": "313-886-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17120 KERCHEVAL AVE",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301661",
            "telephone_number": "318-886-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Hopkinsville St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "KY",
            "postal_code": "423451124",
            "country_code": "US",
            "telephone_number": "270-338-8300",
            "fax_number": "270-338-8427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RINKE",
        "first_name": "LISA",
        "middle_name": "DIANE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4714147850",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704147850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3008817",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704147850",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SUROVICK",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donna D Redd, M.D.
• Anne Marie Reed, N.P.
• Eric A Reim, CRNA
• Shelly A Reim, CRNA
• Steven D Rimar, MD
• Elizabeth Rooney
• Jill Denise Ross, NP
• Sarah L Rosso, MD
• Megan Marie Rousso, PT, DPT
• Rosa Rubino-Frye, M.A., CCC-SLP, CBIS

• Nurse Practitioner in Grosse Pointe, MI
• Providers in Grosse Pointe, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.