Individual provider Active NPI

Diana Lynn Luckhardt, NP

  • Adult Health Nurse Practitioner
  • Ionia, MI
National Provider Identifier
1760767040
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704130092 Issued in MI
Practice address
2622 Heartland Blvd
Ionia, MI 48846-8757
Phone
(517) 913-3860
Fax
(517) 484-6864
NPI assigned
Oct 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704130092 MI Primary

Addresses

Primary practice location

2622 Heartland Blvd
Ionia, MI 48846-8757

Mailing address

1703 East Michigan Avenue
Lansing, MI 48912
Phone (517) 913-3860

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
I20111103000891 MI Practitioner - Nurse Practitioner 5799958914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 E Michigan Ave
700 Sparrow Medical Group Nephrology
Lansing, MI 48912-1837
Phone (517) 364-5550

2601 Coolidge Rd
Suite B
East Lansing, MI 48823-6361
Phone (517) 253-4050

3960 Patient Care Dr
Suite 112
Lansing, MI 48911-4278
Phone (517) 393-0352

550 E Washington St
Ionia, MI 48846-2202
Phone (517) 364-5550

901 S Oakland St
Saint Johns, MI 48879-2255
Phone (989) 227-3456

975 E Townsend Rd
SMG Nephrology
Saint Johns, MI 48879-9299
Phone (989) 224-2662

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association Adult Health CurrentSince Feb 2, 2015 Accepting new patients
Edward W Sparrow Hospital Association Nurse Practitioner CurrentSince Feb 2, 2015 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

111 Lansing St
Ste 100
Charlotte, MI 48813
Phone (517) 364-5550

123 Lansing St
Charlotte, MI 48813
Phone (517) 543-2020

4530 S Hagadorn Rd
Ste A
East Lansing, MI 48823
Phone (517) 333-8414

2601 Coolidge Rd
Ste B
East Lansing, MI 48823
Phone (517) 253-4050

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

2622 Heartland Blvd
Ionia, MI 48846
Phone (616) 522-0265

1703 E Michigan Ave
Lansing, MI 48912
Phone (517) 253-3860

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

300 Health Park Dr
Ste 301
Owosso, MI 48867
Phone (989) 723-3613

901 S Oakland St
Ste 102
Saint Johns, MI 48879
Phone (989) 227-3435

901 S Oakland St
Saint Johns, MI 48879
Phone (517) 227-2338

49641 Grand River Ave
Wixom, MI 48393
Phone (248) 380-0515

Organizations & group practices 4

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 6

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": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1760767040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 EAST MICHIGAN AVENUE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-913-3860",
            "fax_number": "517-484-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 HEARTLAND BLVD",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488468757",
            "telephone_number": "517-913-3860",
            "fax_number": "517-484-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKHARDT",
        "first_name": "DIANA",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704130092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ionia, MI

Sources for this page

Verify at the official NPI Registry.