Individual provider Active NPI

Yulonda Watt

  • Family Nurse Practitioner
  • Novi, MI
National Provider Identifier
1972036382
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704267042 Issued in MI
Practice address
47601 Grand River Ave
Novi, MI 48374-1233
Phone
(248) 465-4100
NPI assigned
Apr 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704267042 MI Primary

Addresses

Primary practice location

47601 Grand River Ave
Novi, MI 48374-1233

Mailing address

22554 Terrace CT Apt 201
Novi, MI 48375-4679

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
I20180116002756 MI Practitioner - Nurse Practitioner 4082973201 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704267042MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longevity Accountable Care, PA CurrentSince Feb 10, 2026 Accepting new patients
Longevity Accountable Care, PA CurrentSince Feb 10, 2026 Accepting new patients

Locations

8045 E Jefferson Ave
Detroit, MI 48214
Phone (313) 821-3525

517 W Page St
Rose City, MI 48654
Phone (989) 685-2442

11700 E 10 Mile Rd
Warren, MI 48089
Phone (586) 353-3800

445 S Valley St
West Branch, MI 48661
Phone (989) 345-3600

Organizations & group practices 4

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1972036382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22554 TERRACE CT APT 201",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483754679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741233",
            "telephone_number": "248-465-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "YULONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704267042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.