Nancy Lee Dorman, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704246796 Issued in MI

Practice address

1975 Stirling Dr
Interlochen, MI 49643-9264

Phone

(231) 275-7965

NPI assigned

Jun 20, 2017

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nancydorman@clhcmi.allscriptsdirect.net

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.

• Crystal Lake Clinic PC

  • Family Medicine Physician
  • Manistee, MI
  • NPI 1134491731
  Medicare reassignment NPD
• Crystal Lake Clinic P.C.

  • Family Medicine Physician
  • Suttons Bay, MI
  • NPI 1164945978
  NPD
• Crystal Lake Clinic P.C.

  • Family Medicine Physician
  • Benzonia, MI
  • NPI 1316991755
  NPD
• Crystal Lake Clinic P.C.

  • Family Medicine Physician
  • Interlochen, MI
  • NPI 1417902057
  NPD (past)
• Crystal Lake Clinic, P.C.

  • Family Medicine Physician
  • Bear Lake, MI
  • NPI 1902851777
  NPD (past)

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1750801940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6227 FRANKFORT HWY",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496168632",
            "telephone_number": "231-882-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 STIRLING DR",
            "city": "INTERLOCHEN",
            "state": "MI",
            "postal_code": "496439264",
            "telephone_number": "231-275-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "NANCY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704246796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Crow
• Crystal Lake Clinic P.C.
• Irene S Danek, M.D.
• Debra E Lewis DDS, PC
• Noel N Demerly, RD
• Dr. Lisa PT LLC
• Dawn Edgley
• Lisa Fernandez, DPT
• Dawn Marie Gaden, M.A., L.P.C., N.C.C.
• Goodwill Optical Inc

• Family Nurse Practitioner in Interlochen, MI
• Providers in Interlochen, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.