Individual provider Active NPI

Lindsay Rutland, CPNP-PC

  • Pediatric Nurse Practitioner
  • Commerce TWP, MI
National Provider Identifier
1811516461
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704310362 Issued in MI
Practice address
8896 Commerce Rd Ste 5
Commerce TWP, MI 48382-4494
Phone
(248) 360-9241
NPI assigned
Apr 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704310362 MI Primary
Registered Nurse 163W00000X 4704310362 MI

Addresses

Primary practice location

8896 Commerce Rd Ste 5
Commerce TWP, MI 48382-4494

Mailing address

9581 Sarasota
Redford, MI 48239-1649

Other practice location 1

5557 Cass Ave
Detroit, MI 48202-3615
Phone (313) 577-5934

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704310362MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Center Pediatrics PC PastSince Oct 11, 2020 Accepting new patients
Bloom Pediatrics PC PastSince Aug 2, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lrutland951593@direct.hfhs.org

Organizations & group practices 2

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": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1811516461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9581 SARASOTA",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8896 COMMERCE RD STE 5",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483824494",
            "telephone_number": "248-360-9241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5557 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482023615",
            "country_code": "US",
            "telephone_number": "313-577-5934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTLAND",
        "first_name": "LINDSAY",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704310362",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704310362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.