Clarisse Michelle Carter

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704238548 Issued in MI

Practice address

26957 Northwestern Hwy
Ste. 400
Southfield, MI 48033-4700

Phone

(248) 687-6764

Fax

(888) 595-4735

NPI assigned

Feb 2, 2007

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifeline Medical CenterGroup PAC ID 3678948577, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clarisse.carter.1@28492.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4
• Direct secure messaging: ccarter136861@direct.hfhs.org

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.

• Lifeline Medical Center

  • Family Medicine Physician
  • Anderson, IN
  • NPI 1265160451

  Family, MI

  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1104900455

  MI, Nurse Practitioner

  Medicare reassignment NPD
• New Life Alternatives LLC

  • Multi-Specialty Clinic/Center
  • Berkley, MI
  • NPI 1033759659

  MI

  Medicare reassignment NPD
• Osh-Mi Physicians Group PC

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1700236478

  MI

  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Portage, MI
  • NPI 1669091864

  MI

  Medicare reassignment NPD
• Molina Care Connections, LLC.

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  MI, Nurse Practitioner

  Medicare reassignment NPD
• Severia Adolphus, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Clair Shores, MI
  • NPI 1992939052

  MI

  Medicare reassignment
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Vpa PC

  • Family Medicine Physician
  • Troy, MI
  • NPI 1336153295
  NPD
• Osh Mi Physicians Group, PC

  • Primary Care Clinic/Center
  • Memphis, TN
  • NPI 1720635790
  NPD
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD
• HCR Manorcare Medical Services of Florida LLC

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1386750420
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1932247889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26957 NORTHWESTERN HWY",
            "address_2": "STE. 400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334700",
            "telephone_number": "248-687-6764",
            "fax_number": "888-595-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "CLARISSE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704238548",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704238548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kioko Trinity Carruthers
• Porsche Carson
• Carter Spinal Orthopedic and Sports Rehab
• Beatrice Ann Carter
• Beth A Carter, MD
• Jacquelyne Ann Carter
• Julianna Carter
• Karen Sue Carter, LMSW
• Latoyia Carter
• Melanie Carter, NP

• All providers in Southfield, MI
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.