Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1689626400 Individual Practitioner Female Practitioner

Dr. Lenae E Vanwagnen , MD

Pediatrics • Jackson, MI

Professional Overview & Biography Verified Profile Summary

Dr. Lenae Vanwagnen, MD is a registered healthcare professional specializing in Pediatrics in Jackson, MI. Practice services are available at 1310 GREENWOOD AVE LOWR LEVEL under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1310 Greenwood Ave Lowr Level

Jackson, MI 492033077

Telephone 5179620123
Fax 5172018067
Associated Practice Facility / Clinic
🏢 Lenae E Vanwagnen Md Llc Facility NPI 1811798697

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Jackson, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.0 Yrs
State Avg: 25.7 Yrs
Regional Practice Density
23 Specialists

Practicing in Jackson, MI (2263 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-01
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License MI 4301076691

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
4538139 (MI)
Commercial Insurance / Payer ID Php
200000005064 (MI)
Commercial Insurance / Payer ID Bcbs
3503810402 (MI)
Commercial Insurance / Payer ID Aetna
7766500 (MI)
Commercial Insurance / Payer ID Preferred Choices
139374 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Tara Ziecina , FNP-C

Nurse Practitioner - Family

NPI 1174098198

Family Nurse Practitioner (Certified)

Susan Beck , CPNP

Nurse Practitioner - Pediatrics

NPI 1265533764

Certified Pediatric Nurse Practitioner

Jennifer Urabe , FNP

Nurse Practitioner - Family

NPI 1639545932

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Business Mailing Address April 18, 2025

Registered at 1310 GREENWOOD AVE LOWR LEVEL, JACKSON, MI 492033077 (Tel: 5179620123)

📍
Updated Practice Location April 04, 2025

Registered at 1310 GREENWOOD AVE LOWR LEVEL, JACKSON, MI 492033077 (Tel: 5179620123)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 04, 2025

Pediatrics (License #4301076691 in MI)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2100 4TH ST, JACKSON, MI 492034518 (Tel: 5177874330)

📍
Updated Business Mailing Address July 08, 2007

Registered at 2100 4TH ST, JACKSON, MI 492034518 (Tel: 5177874330)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as LENAE VANWAGNEN, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #4301076691 in MI)

🟢
Initial NPI Registration & Enumeration May 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689626400
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 17, 2006
Last Update: July 01, 2026
Sole Proprietor: No

Mailing Address

1310 Greenwood Ave Lowr Level

Jackson, MI 492033077

Phone: 5179620123

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.