Individual provider Active NPI

Ryan C Upson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1891032439
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704234352 Issued in MI
Practice address
3475 Belle Chase Way
Lansing, MI 48911-4252
Phone
(517) 882-3732
NPI assigned
Jan 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704234352 MI Primary

Addresses

Primary practice location

3475 Belle Chase Way
Lansing, MI 48911-4252

Mailing address

812 E Jolly Rd
Suite 210
Lansing, MI 48910-6818
Phone (514) 346-8000

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
I20200430000296 MI Practitioner - Nurse Practitioner 1759711963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

4136 Legacy Pkwy
Lansing, MI 48911-4265
Phone (517) 882-3732

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704234352MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Jan 12, 2022 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Jan 12, 2022 Accepting new patients

Locations

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

4136 Legacy Pkwy
Lansing, MI 48911
Phone (517) 492-0517

3475 Belle Chase Way
Lansing, MI 48911
Phone (517) 744-7389

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.ryanupson@150339.advancedmd-direct.com

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": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1891032439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "address_2": "SUITE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818",
            "telephone_number": "514-346-8000",
            "fax_number": "514-346-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 BELLE CHASE WAY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114252",
            "telephone_number": "517-882-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPSON",
        "first_name": "RYAN",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-15",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704234352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.