Individual provider Active NPI

Lucy Thompson

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1851922405
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704330108 Issued in MI
Practice address
245 Cherry St SE Ste 306
Grand Rapids, MI 49503-4607
Phone
(616) 685-8750
Fax
(616) 685-8002
NPI assigned
Feb 3, 2020
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 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 4704330108 MI Primary

Addresses

Primary practice location

245 Cherry St SE Ste 306
Grand Rapids, MI 49503-4607

Mailing address

PO Box 776974
Chicago, IL 60677-6974
Phone (231) 672-2119

Other identifiers 1

IdentifierTypeStateIssuer
1851922405MedicaidMI

Other names 1

  • Lucy Montanaro Former name

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
I20230703001073 MI Practitioner - Nurse Practitioner 7012376494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

245 Cherry St SE
Suite 306
Grand Rapids, MI 49503-4607
Phone (616) 685-8750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704330108MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group Nurse Practitioner CurrentSince Jun 1, 2023 Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Jun 1, 2023 Accepting new patients
Treece Home Care Inc PastSince Feb 1, 2020 Accepting new patients
Advantage Health Saint Mary's Medical Group Past Accepting new patients

Locations

2373 64th St SW
Byron Center, MI 49315
Phone (616) 685-1350

2373 64th St SW
Ste 1300
Byron Center, MI 49315
Phone (616) 685-1350

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

245 Cherry St SE
Ste 306
Grand Rapids, MI 49503
Phone (616) 685-8750

3925 32nd Ave
Ste 300
Hudsonville, MI 49426
Phone (616) 685-1500

6050 Northland Dr NE
Ste 200
Rockford, MI 49341
Phone (616) 685-8350

Interoperability endpoints

  • Direct secure messaging: lthompson33001@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1851922405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776974",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776974",
            "telephone_number": "231-672-2119",
            "fax_number": "313-432-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CHERRY ST SE STE 306",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034607",
            "telephone_number": "616-685-8750",
            "fax_number": "616-685-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LUCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704330108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851922405",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCY",
            "last_name": "MONTANARO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.