Individual provider Active NPI

Mara Christine Nieman, NP-C

  • Family Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1982247276
Registry record updated Oct 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F09191341 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(248) 898-5000
NPI assigned
Oct 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2019

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 F09191341 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

937 Marvell PL
Waterford, MI 48327-3120
Phone (586) 214-1762

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
I20200403000839 MI Practitioner - Nurse Practitioner 3678902129 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F09191341MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Critical Care & Pulmonary Consultants PLLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

27901 Woodward Ave
Ste 220
Berkley, MI 48072
Phone (248) 399-5492

6255 Inkster Rd
Ste 307
Garden City, MI 48135
Phone (248) 556-5582

17177 N Laurel Park Dr
Ste 439
Livonia, MI 48152

3601 W 13 Mile Rd
Royal Oak, MI 48073

Organizations & group practices 1

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": "1571529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571529600000",
    "number": "1982247276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 MARVELL PL",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273120",
            "telephone_number": "586-214-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMAN",
        "first_name": "MARA",
        "middle_name": "CHRISTINE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-20",
        "last_updated": "2019-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F09191341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.