Nancy Jo Fantetti, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704206107 Issued in MI

Practice address

2002 S 11TH St
Niles, MI 49120-4074

Phone

(269) 687-0200

Fax

(269) 684-0199

NPI assigned

May 16, 2012

Last updated

Aug 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Community Hospital WatervlietGroup PAC ID 7416942750, shared by 7 NPIs, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
• Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
• Direct secure messaging: nfantetti1269383@epic00.corewelldirect.org

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.

• Beacon Dowagiac Inc

  dba Beacon Dowagiac

  • Rural Health Clinic/Center
  • Dowagiac, MI
  • NPI 1194717504
  Medicare reassignment NPD
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital Primary Care - Hartford

  • Rural Health Clinic/Center
  • Hartford, MI
  • NPI 1023114741
  Medicare reassignment NPD
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital Southwestern Medical Multispecial

  • Rural Health Clinic/Center
  • Niles, MI
  • NPI 1538592753
  Medicare reassignment NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment NPD
• Beacon Dowagiac Inc

  dba Beacon Kalamazoo

  • Hospitalist Physician
  • Dowagiac, MI
  • NPI 1467315499
  NPD
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital

  • Rural Health Clinic/Center
  • Dowagiac, MI
  • NPI 1184467607
  NPD
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospitals

  • Rural Health Clinic/Center
  • Watervliet, MI
  • NPI 1508924770
  NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital Primary Care - Coloma

  • Rural Health Clinic/Center
  • Coloma, MI
  • NPI 1083710701
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital

  • General Acute Care Hospital
  • Watervliet, MI
  • NPI 1700994845
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  dba Corewell Health Lakeland Hospitals

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1891054458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204074",
            "telephone_number": "269-687-0200",
            "fax_number": "269-684-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204074",
            "telephone_number": "269-687-0200",
            "fax_number": "269-684-0199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465441948",
            "country_code": "US",
            "telephone_number": "219-462-7173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANTETTI",
        "first_name": "NANCY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28125230A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704206107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunice Hamilton, NP (Better Living Health Services)
• Eurisko Vocational Services, LLC
• Everkind Care, LLC
• Derek Alan Ewald, ATC
• Michele Angela Fanfair-Steury, MSW
• Christopher H Faris, DPM
• Peter Fauver, M.S.
• Brad S Ferrari, MD
• Michael James Fillmore, LLMSW
• Alena Flegel

• Family Nurse Practitioner in Niles, MI
• Providers in Niles, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.