Mphasa Mwanza, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704263078 Issued in MI

Practice address

261 M 62
Cassopolis, MI 49031-1034

Phone

(269) 445-3874

NPI assigned

Oct 12, 2015

Sex

Female

Sole proprietor

No

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Immediate Care CenterGroup PAC ID 2264423771, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmwanza1271036@epic00.shdirect.org

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.

• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Cassopolis, MI
  • NPI 1982677548
  Medicare reassignment Care Compare group NPD
• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Dowagiac, MI
  • NPI 1881492338
  NPD

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

• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1700257151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 M 62",
            "city": "CASSOPOLIS",
            "state": "MI",
            "postal_code": "490311034",
            "telephone_number": "269-445-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 M 62",
            "city": "CASSOPOLIS",
            "state": "MI",
            "postal_code": "490311034",
            "telephone_number": "269-445-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANZA",
        "first_name": "MPHASA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704263078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scot K Moore, DVM
• Matosha Morin
• Corey Chad Morrow
• Jody Murmu
• Tamantha Renee Murphy, LLMSW
• Kelley A Nickel, CPRM CPS RN
• Nicole Rae Norton, NP
• Cecily Ogden
• Gregory Outlaw, QMHP
• Tom M Pabreza, LBSW

• Primary Care Nurse Practitioner in Cassopolis, MI
• Providers in Cassopolis, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.