Individual provider Active NPI

Denise Soltow Hershey, N.P.

  • Family Nurse Practitioner
  • East Lansing, MI
National Provider Identifier
1710933783
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704150738 Issued in MI
Practice address
804 Service Road
Room A142
East Lansing, MI 48824-1313
Phone
(517) 353-3050
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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 4704150738 MI Primary

Addresses

Primary practice location

804 Service Road
Room A142
East Lansing, MI 48824-1313

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 353-4911

Other identifiers 2

IdentifierTypeStateIssuer
4554295MedicaidMI
1710933783MedicaidMI

Other names 1

  • Denise M Soltow Former name

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
I20031229000875 MI Practitioner - Nurse Practitioner 1759289754 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

804 Service Rd
East Lansing, MI 48824-7015
Phone (517) 353-2562

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704150738MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc CurrentSince Jul 1, 2020 Accepting new patients
Michigan State University Current Accepting new patients
Msu Health Care Inc. CurrentSince Jul 1, 2020 Accepting new patients

Locations

804 Service Rd
Ste A110
East Lansing, MI 48824
Phone (517) 353-3003

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

804 Service Rd
Ste A225
East Lansing, MI 48824
Phone (517) 353-2562

804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976

Interoperability endpoints

  • Direct secure messaging: denise.hershey.1@25394.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1710933783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-4911",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SERVICE ROAD",
            "address_2": "ROOM A142",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241313",
            "telephone_number": "517-353-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHEY",
        "first_name": "DENISE",
        "middle_name": "SOLTOW",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704150738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4554295",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710933783",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "SOLTOW",
            "middle_name": "M",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.