Individual provider Active NPI

Lynne Marie Lounsbury, CNP

  • Nurse Practitioner
  • Paw Paw, MI
National Provider Identifier
1861492423
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704145261 Issued in MI
Practice address
451 Health Pkwy
Suite B
Paw Paw, MI 49079-8242
Phone
(269) 655-3065
Fax
(269) 655-0588
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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 4704145261 MI Primary

Addresses

Primary practice location

451 Health Pkwy
Suite B
Paw Paw, MI 49079-8242

Mailing address

451 Health Pkwy
Suite B
Paw Paw, MI 49079-8242
Phone (269) 655-3065

Other identifiers 3

IdentifierTypeStateIssuer
105174835MedicaidMI
700H060020OtherMIBCBSM
1861492423MedicaidMI

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
I20080314000546 MI Practitioner - Nurse Practitioner 0547345522 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704145261MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed CurrentSince May 15, 2017 Accepting new patients
Promed Healthcare CurrentSince May 15, 2017 Accepting new patients

Locations

1717 Shaffer St
Kalamazoo, MI 49048
Phone (269) 226-5050

1717 Shaffer St
Ste 124
Kalamazoo, MI 49048
Phone (269) 226-5456

451 Health Pkwy
Ste B
Paw Paw, MI 49079
Phone (269) 655-3065

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1861492423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "address_2": "SUITE B",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-655-3065",
            "fax_number": "269-655-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "address_2": "SUITE B",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-655-3065",
            "fax_number": "269-655-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUNSBURY",
        "first_name": "LYNNE",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704145261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105174835",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "700H060020",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861492423",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paw Paw, MI

Sources for this page

Verify at the official NPI Registry.