DARLA DANE (NP) – Nurse Practitioner, NPI 1417619214

DARLA DANE (NP) is a healthcare provider. based in Grand rapids, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 0030094 (OH). The NPI Number for DARLA DANE (NP) is 1417619214

Main info

Female
7 Years Of Experience
Name
DARLA DANE (NP)
NPI
1417619214
Phone
(616) 421-9387
Address
710 KENMOOR AVE SE STE 100
Enumeration Date
8 October 2021
Last Update Date
24 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6162220631
Graduation Year
2019 (7 years ago)
PAC ID
5092100990
Group Practice PAC ID
6103190335
Professional Enrollment ID
I20220310002561
Address ID
MI494189494WY4124XSWXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:4State licenses:3Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for DARLA DANE (NP)

  • 710 KENMOOR AVE SE STE 100

    GRAND RAPIDS, MI 495462379

    Phone: (616) 421-9387

    Type: Mailing

  • 7570 WEMBLEY CT

    TEMPERANCE, MI 481829180

    Phone: (419) 973-9484

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-03-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220310002561INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49546)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103190335View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Mental Health CounselorMI
Mental Health CounselorMI
Mental Health CounselorMI
Nurse PractitionerMI
Mental Health CounselorMI
Mental Health CounselorMI
Nurse PractitionerMI
Clinical Social WorkerMI
Clinical Social WorkerMI

Reviews

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Frequently asked questions

What NPI should I save for DARLA DANE (NP)?
Save NPI 1417619214 if you need a stable reference for DARLA DANE (NP).
Does this profile mean DARLA DANE (NP) is currently active?
Yes — DARLA DANE (NP) appears active in the national provider directory.
Can you summarize DARLA DANE (NP)'s specialty in plain language?
Clinically, the directory lists DARLA DANE (NP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for DARLA DANE (NP)?
The page summarizes Grand Rapids, Michigan for DARLA DANE (NP); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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