Individual provider Active NPI

Amy Wolfe, NP-C

  • Nurse Practitioner
  • East Lansing, MI
National Provider Identifier
1780031484
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704274427 Issued in MI
Practice address
1750 E Grand River Ave
Suite 103
East Lansing, MI 48823-4958
Phone
(517) 333-7113
Fax
(517) 333-7125
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704274427 MI Primary

Addresses

Primary practice location

1750 E Grand River Ave
Suite 103
East Lansing, MI 48823-4958

Mailing address

1750 E Grand River Ave
Suite 103
East Lansing, MI 48823-4958
Phone (517) 333-7113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704274427MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbridge of Clarkston, LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1780031484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 E GRAND RIVER AVE",
            "address_2": "SUITE 103",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488234958",
            "telephone_number": "517-333-7113",
            "fax_number": "517-333-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E GRAND RIVER AVE",
            "address_2": "SUITE 103",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488234958",
            "telephone_number": "517-333-7113",
            "fax_number": "517-333-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "AMY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704274427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.