Individual provider Active NPI

Shari Visscher, FNP-C

  • Family Nurse Practitioner
  • Holland, MI
National Provider Identifier
1720763964
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704169836 Issued in MI
Practice address
382 N 120TH Ave
Holland, MI 49424-2169
Phone
(616) 396-6516
Fax
(616) 396-2513
NPI assigned
Jun 15, 2023
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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 4704169836 MI Primary

Addresses

Primary practice location

382 N 120TH Ave
Holland, MI 49424-2169

Mailing address

382 N 120TH Ave
Holland, MI 49424-2169
Phone (616) 396-6516

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
I20231012003352 MI Practitioner - Nurse Practitioner 4981059896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Family Medicine PLCGroup PAC ID 0749290740, 16 clinicians

Practice addresses (Care Compare)

382 N 120TH Ave
Holland, MI 49424-2169
Phone (616) 396-6516

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704169836MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Family Medicine PLC CurrentSince May 6, 2024 Accepting new patients

Locations

382 N 120th Ave
Holland, MI 49424
Phone (616) 396-6516

Interoperability endpoints

  • Direct secure messaging: shari.visscher.p1@direct.oam.nextgenshare.com

Organizations & group practices 1

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 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": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1720763964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 N 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242169",
            "telephone_number": "616-396-6516",
            "fax_number": "616-396-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 N 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242169",
            "telephone_number": "616-396-6516",
            "fax_number": "616-396-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISSCHER",
        "first_name": "SHARI",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704169836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.