Organization Active NPI

Lenae E Vanwagnen MD LLC

  • Pediatrics Physician
  • Jackson, MI
National Provider Identifier
1811798697
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LENAE E VANWAGNEN MD LLC
Practice address
1310 Greenwood Ave Lowr Level
Jackson, MI 49203-3077
Phone
(517) 962-0123
Fax
(517) 201-8067
NPI assigned
Mar 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Lenae Elizabeth Vanwagnen, MDNPI 1689626400
Title
Owner
Phone
(517) 962-0123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1310 Greenwood Ave Lowr Level
Jackson, MI 49203-3077

Mailing address

1310 Greenwood Ave
Jackson, MI 49203-3077
Phone (517) 962-0123

Other names 1

  • Bright Beginnings Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2320620Lenae E Vanwagnen MD1310 Greenwood Avenue, Jackson, MI 49203Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Locations

1310 Greenwood Ave
Jackson, MI 49203
Phone (517) 787-1990

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1742342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1811798697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 GREENWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033077",
            "telephone_number": "517-962-0123",
            "fax_number": "517-201-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 GREENWOOD AVE LOWR LEVEL",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033077",
            "telephone_number": "517-962-0123",
            "fax_number": "517-201-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LENAE E VANWAGNEN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-19",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "VANWAGNEN",
        "authorized_official_first_name": "LENAE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-962-0123",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Beginnings Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bright Beginnings Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (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.