Individual provider Active NPI

Melinda R Sandberg, NP-C

  • Family Nurse Practitioner
  • Dewitt, MI
National Provider Identifier
1861069254
Registry record updated Jun 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704324782 Issued in MI
Practice address
11300 Wood Rd
Dewitt, MI 48820-8341
Phone
(989) 860-0225
NPI assigned
Jun 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2021

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 4704324782 MI Primary

Addresses

Primary practice location

11300 Wood Rd
Dewitt, MI 48820-8341

Mailing address

11300 Wood Rd
Dewitt, MI 48820-8341
Phone (989) 860-0225

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
I20220701001394 MI Practitioner - Nurse Practitioner 1355721770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Greater LansingGroup PAC ID 7214833466, 96 clinicians

Practice addresses (Care Compare)

3520 Forest Rd
Lansing, MI 48910-3720
Phone (877) 296-0111

Hospital & facility affiliations

  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704324782MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Greater Lansing Nurse Practitioner CurrentSince Aug 1, 2022 Accepting new patients
McLaren Greater Lansing CurrentSince Aug 1, 2022 Accepting new patients
McLaren Greater Lansing Current Accepting new patients
Mid-Michigan Physicians, PC Nurse Practitioner Past Accepting new patients
McLaren Greater Lansing Past Accepting new patients

Locations

3520 Forest Rd
Ste 200
Lansing, MI 48910

3520 Forest Rd
Lansing, MI 48910
Phone (517) 975-7800

405 W Greenlawn Ave
Ste 305
Lansing, MI 48910
Phone (517) 483-4780

Organizations & group practices 5

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 3

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": "1622851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622851200000",
    "number": "1861069254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 WOOD RD",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208341",
            "telephone_number": "989-860-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 WOOD RD",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208341",
            "telephone_number": "989-860-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "MELINDA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-05",
        "last_updated": "2021-06-05",
        "certification_date": "2021-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704324782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dewitt, MI

Sources for this page

Verify at the official NPI Registry.