Leda Theres Evans – Adult Health Nurse Practitioner

Key facts

NPI: 1780133694
Entity type: Individual (NPI type 1)
Primary specialty: Adult Health Nurse Practitioner 363LA2200X
License: 4704256163 (MI)
Practice address: 1175 Wilson Ave NW
Walker, MI 49534-6407
Phone: (616) 685-8650
Fax: (616) 791-2160
NPI assigned: Oct 4, 2016
Sex: Female
Sole proprietor: No

Organizations & group practices 3

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.

Advantage Health/Saint Mary'S Medical Group Multi-Specialty Clinic/Center · Grand Rapids, MI · NPI 1376862151

Medicare reassignment Care Compare group NPD MI
Advantage Health Saint Mary'S Medical Group Orthopaedic Surgery Physician · Byron Center, MI · NPI 1003515008

NPD
Advantage Health Saint Mary'S Medical Group Multi-Specialty Clinic/Center · Grand Rapids, MI · NPI 1952340911

NPD (past)

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Saint Mary'S Health Services General Acute Care Hospital · Grand Rapids, MI · NPI 1639111057

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2016
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Advantage Health/Saint Mary'S Medical Group (499 clinicians)

Practice addresses (Care Compare)

1175 Wilson Ave NW
Walker, MI 49534-6407
Phone (616) 685-8650

Hospital & facility affiliations

Mercy Health Saint Mary'S Hospital · Grand Rapids, MI · CCN 230059

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20161024000691	MI	Practitioner - Nurse Practitioner	4587942727	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
4704256163	MI	MD	Adult Health Nurse Practitioner

Practice roles

Organization	Status	New patients
Advantage Health Saint Mary'S Medical Group	Current since Dec 1, 2016	Accepting new patients
Advantage Health/Saint Mary'S Medical Group	Current since Dec 1, 2016	Accepting new patients
Advantage Health Saint Mary'S Medical Group	Past	Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

300 Lafayette Ave SE
Ste 2045
Grand Rapids, MI 49503
Phone (616) 685-3098

1175 Wilson Ave NW
Walker, MI 49534
Phone (616) 284-3686

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Adult Health Nurse Practitioner	363LA2200X	4704256163	MI	Yes

Addresses

Primary practice location

1175 Wilson Ave NW
Walker, MI 49534-6407

Mailing address

1900 44TH St SE
Kentwood, MI 49508-5008
Phone (616) 685-1808

Other names

Leda Theres Turner Former name

Other providers in Walker, MI

All providers in Walker, MI · Adult Health Nurse Practitioner in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.