Individual provider Active NPI

Jenny Lee Werth, NP-C

  • Family Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1770867657
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704263382 Issued in MI
Practice address
1215 E. Michigan Ave
Trauma Center
Lansing, MI 48912
Phone
(517) 364-1000
Fax
(517) 364-3525
NPI assigned
Oct 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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 4704263382 MI Primary

Addresses

Primary practice location

1215 E. Michigan Ave
Trauma Center
Lansing, MI 48912

Mailing address

804 Service Rd A201
East Lansing, MI 48824-7015
Phone (517) 884-2976

Other identifiers 1

IdentifierTypeStateIssuer
1770867657MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000044 MI Practitioner - Nurse Practitioner 7810162450 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704263382MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice Advantage, LLC Family CurrentSince Sep 8, 2021 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Hospice Advantage, LLC Family CurrentSince Sep 8, 2021 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Dec 1, 2015 Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2682 E Grand River Ave
East Lansing, MI 48823
Phone (517) 333-6352

801 S Waverly Rd
Ste 200
Lansing, MI 48917
Phone (517) 300-0340

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

1200 E Michigan Ave
Ste 655
Lansing, MI 48912
Phone (517) 267-2460

1200 E Michigan Ave
Lowr
Lansing, MI 48912
Phone (517) 364-5252

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

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

10 Cadillac Dr
Ste 400
Brentwood, TN 37027
Phone (615) 637-9163

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1770867657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD A201",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E. MICHIGAN AVE",
            "address_2": "TRAUMA CENTER",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48912",
            "telephone_number": "517-364-1000",
            "fax_number": "517-364-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTH",
        "first_name": "JENNY",
        "middle_name": "LEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704263382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770867657",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.