Individual provider Active NPI

Joy Ellen Lepo, AGPCNP-BC

  • Nurse Practitioner
  • Grand Haven, MI
National Provider Identifier
1982439899
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704216391 Issued in MI
Practice address
15491 Lake Ave
Grand Haven, MI 49417-8506
Phone
(616) 638-3840
NPI assigned
Sep 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704216391 MI Primary

Addresses

Primary practice location

15491 Lake Ave
Grand Haven, MI 49417-8506

Mailing address

15491 Lake Ave
Grand Haven, MI 49417-8506
Phone (616) 638-3840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704216391MIMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1982439899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15491 LAKE AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494178506",
            "telephone_number": "616-638-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15491 LAKE AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494178506",
            "telephone_number": "616-638-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPO",
        "first_name": "JOY",
        "middle_name": "ELLEN",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704216391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.