Individual provider Active NPI

Lauren Perun

  • Nurse Practitioner
  • Rockford, MI
National Provider Identifier
1821865338
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704336221 Issued in MI
Practice address
7018 Kitson Dr NE
Rockford, MI 49341-8545
Phone
(810) 569-3091
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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 4704336221 MI Primary

Addresses

Primary practice location

7018 Kitson Dr NE
Rockford, MI 49341-8545

Mailing address

7018 Kitson Dr NE
Rockford, MI 49341-8545
Phone (810) 569-3091

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529002139 MI Practitioner - Nurse Practitioner 3971945411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Age Management of West Michigan PCGroup PAC ID 2466686290, 23 clinicians
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

1959 E Paris Ave SE
Grand Rapids, MI 49546-6272
Phone (616) 808-2695

300 Lafayette Ave SE
Suite 3200
Grand Rapids, MI 49503-4692
Phone (616) 685-6920

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Age Management of West Michigan PC CurrentSince May 1, 2024 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Mar 15, 2026 Accepting new patients
Advantage Health Saint Mary'S Medical Group Nurse Practitioner CurrentSince Mar 15, 2026 Accepting new patients

Locations

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

1959 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 285-3700

300 Lafayette Ave SE
Ste 3200
Grand Rapids, MI 49503
Phone (616) 685-6920

300 Lafayette Ave SE
Ste 3400
Grand Rapids, MI 49503
Phone (616) 685-6497

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1821865338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7018 KITSON DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418545",
            "telephone_number": "810-569-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7018 KITSON DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418545",
            "telephone_number": "810-569-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUN",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704336221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, MI

Sources for this page

Verify at the official NPI Registry.