Individual provider Active NPI

Laura Fanning

  • Family Nurse Practitioner
  • Saint Johns, MI
National Provider Identifier
1851886469
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704253569 Issued in MI
Practice address
901 S Oakland St Ste 201
Saint Johns, MI 48879-2200
Phone
(989) 224-2338
Fax
(989) 224-2065
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704253569 MI Primary

Addresses

Primary practice location

901 S Oakland St Ste 201
Saint Johns, MI 48879-2200

Mailing address

PO Box 13008
Lansing, MI 48901-3008
Phone (989) 224-2338

Other identifiers 1

IdentifierTypeStateIssuer
4704253569OtherMISTATE LICENSE

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
I20180809001028 MI Practitioner - Nurse Practitioner 2163770058 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, 698 clinicians

Practice addresses (Care Compare)

2900 Hannah Blvd
Suite 114
East Lansing, MI 48823-5380
Phone (517) 364-8080

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • University of Michigan Health- Sparrow Clinton Hospital, Saint Johns, MI, CCN 231326
  • University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Clinton Hospital CurrentSince Aug 1, 2018 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Oct 6, 2024 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Oct 6, 2024 Accepting new patients
Sparrow Clinton Hospital Current Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

2900 Hannah Blvd
Ste 114
East Lansing, MI 48823
Phone (517) 364-8080

901 S Oakland St
Ste 201
Saint Johns, MI 48879
Phone (989) 224-2338

901 S Oakland St
Saint Johns, MI 48879
Phone (517) 227-2338

Organizations & group practices 6

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 6

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1851886469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "989-224-2338",
            "fax_number": "989-224-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S OAKLAND ST STE 201",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488792200",
            "telephone_number": "989-224-2338",
            "fax_number": "989-224-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704253569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4704253569",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, MI

Sources for this page

Verify at the official NPI Registry.