Individual provider Active NPI

Lisa M. Lindsay, CNP

  • Gerontology Nurse Practitioner
  • Davison, MI
National Provider Identifier
1962507947
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704196224 Issued in MI
Practice address
2281 N Baxter Rd
Davison, MI 48423-8104
Phone
(810) 785-4034
Fax
(810) 787-3254
NPI assigned
Sep 14, 2006
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704196224 MI Primary

Addresses

Primary practice location

2281 N Baxter Rd
Davison, MI 48423-8104

Mailing address

2281 N Baxter Rd
Davison, MI 48423-8104
Phone (810) 785-4034

Other identifiers 2

IdentifierTypeStateIssuer
5008701230OtherMIBLUE SHIELD
4511663MedicaidMI

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
I20041014000893 MI Practitioner - Nurse Practitioner 9931169802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Davison, MI 48423
Phone (810) 845-8775

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes in-Home Clinician Services Inc Nurse Practitioner Past Accepting new patients
Prime Medical Group PC Nurse Practitioner PastSince Feb 9, 2026 Accepting new patients

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 5

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1962507947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 N BAXTER RD",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484238104",
            "telephone_number": "810-785-4034",
            "fax_number": "810-787-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2281 N BAXTER RD",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484238104",
            "telephone_number": "810-785-4034",
            "fax_number": "810-787-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "LISA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704196224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "5008701230",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4511663",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davison, MI

Sources for this page

Verify at the official NPI Registry.