Individual provider Active NPI

Sophia Updyke

  • Women's Health Nurse Practitioner
  • East Lansing, MI
National Provider Identifier
1861955601
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
4704311684 Issued in MI
Practice address
1560 Turf LN
East Lansing, MI 48823-6392
Phone
(517) 484-3000
NPI assigned
Apr 9, 2019
Last updated
Jun 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704311684 MI Primary
Registered Nurse 163W00000X 4704311684 MI

Addresses

Primary practice location

1560 Turf LN
East Lansing, MI 48823-6392

Mailing address

401 W Greenlawn Ave
Lansing, MI 48910-2819
Phone (517) 975-6000

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
I20230104000834 MI Practitioner - Nurse Practitioner 9830569003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uwh of Michigan PLCGroup PAC ID 0345626073, 91 clinicians

Practice addresses (Care Compare)

1560 Turf LN
East Lansing, MI 48823-6392
Phone (517) 484-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704311684MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Obstetrics & Gynecology, PLLC CurrentSince Jun 26, 2022 Accepting new patients
Uwh of Michigan PLC CurrentSince Nov 1, 2022 Accepting new patients
Women's Health Consultants, PLC PastSince Jul 1, 2016 Accepting new patients

Locations

1560 Turf Ln
East Lansing, MI 48823
Phone (517) 484-3000

1100 S Cedar St
Mason, MI 48854
Phone (517) 484-3000

46325 W Twelve Mile Rd
Ste 250
Novi, MI 48377
Phone (248) 465-1200

Interoperability endpoints

  • Direct secure messaging: sophia.updyke.1@26060.direct.athenahealth.com

Organizations & group practices 3

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 2

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1861955601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W GREENLAWN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102819",
            "telephone_number": "517-975-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 TURF LN",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236392",
            "telephone_number": "517-484-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPDYKE",
        "first_name": "SOPHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704311684",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704311684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.