Individual provider Active NPI

Lindsay Marlatt

  • Gerontology Nurse Practitioner
  • Port Huron, MI
National Provider Identifier
1851969844
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704285737 Issued in MI
Practice address
1210 10TH Ave
Port Huron, MI 48060-3406
Phone
(810) 662-3505
Fax
(810) 662-3479
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704285737 MI
Gerontology Nurse Practitioner 363LG0600X 4704285737 MI Primary

Addresses

Primary practice location

1210 10TH Ave
Port Huron, MI 48060-3406

Mailing address

3300 Berkshire St
Port Huron, MI 48060-1641
Phone (810) 531-9591

Other practice location 1

3300 Berkshire St
Port Huron, MI 48060-1641
Phone (810) 531-9591

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
I20231212003739 MI Practitioner - Nurse Practitioner 9436508751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Transitional Care Services LLCGroup PAC ID 6709165954, 45 clinicians

Practice addresses (Care Compare)

4568 W Walton Blvd
Suite D
Waterford, MI 48329-4900
Phone (855) 466-3631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704285737MIMDRegistered Nurse

Interoperability endpoints

  • Direct secure messaging: ms_lmarlatt@landmarkhealth-direct.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": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1851969844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 BERKSHIRE ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601641",
            "telephone_number": "810-531-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 10TH AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603406",
            "telephone_number": "810-662-3505",
            "fax_number": "810-662-3479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Berkshire St",
            "address_purpose": "LOCATION",
            "city": "Port Huron",
            "state": "MI",
            "postal_code": "480601641",
            "country_code": "US",
            "telephone_number": "810-531-9591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARLATT",
        "first_name": "LINDSAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704285737",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704285737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.