Individual provider Active NPI

Timothy Laurin, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wyandotte, MI
National Provider Identifier
1700214665
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704302316 Issued in MI
Practice address
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone
(734) 246-6000
NPI assigned
Oct 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704302316 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704302316 MI Primary

Addresses

Primary practice location

2333 Biddle Ave
Wyandotte, MI 48192-4668

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (138) 744-8063

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tlaurin2@hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140224001869 MI Practitioner - Certified Clinical Nurse Specialist (CNS) 3274763040 Reassigns benefits to 1 organization
I20211118001719 MI Practitioner - Nurse Practitioner 3274763040

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians

Practice addresses (Care Compare)

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 284-2400

Hospital & facility affiliations

  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704302316MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Wyandotte Hospital Current Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Feb 19, 2017 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Feb 19, 2017 Accepting new patients

Locations

1640 Fort St
Ste D
Trenton, MI 48183
Phone (734) 391-3057

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

Interoperability endpoints

  • Direct secure messaging: tlaurin260700@direct.hfhs.org

Organizations & group practices 3

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 2

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": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1700214665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "138-744-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668",
            "telephone_number": "734-246-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURIN",
        "first_name": "TIMOTHY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-30",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704302316",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704302316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlaurin2@hfhs.org",
            "affiliation": "N",
            "address_1": "2333 Biddle Ave",
            "city": "Wyandotte",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481924668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.