Individual provider Active NPI

Ciara L Eatmon, NP

  • Nurse Practitioner
  • Grosse Pointe Farms, MI
National Provider Identifier
1093284564
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1093284564 Issued in MI
Practice address
18700 Mack Ave
Grosse Pointe Farms, MI 48236-2923
Phone
(313) 925-3486
Fax
(313) 925-3497
NPI assigned
Nov 14, 2018
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95010333 CA
Nurse Practitioner 363L00000X 1093284564 MI Primary

Addresses

Primary practice location

18700 Mack Ave
Grosse Pointe Farms, MI 48236-2923

Mailing address

19179 McCormick St
Detroit, MI 48224-1017
Phone (313) 605-0095

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ceatmon1@hfhs.org Henry Ford Health System

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
I20190417000337 MI Practitioner - Nurse Practitioner 3173864352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

18700 Mack Ave
Grosse Pointe Farms, MI 48236-2923
Phone (313) 925-3486

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95010333CAMDNurse Practitioner
1093284564MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Park Rehabilitation PC CurrentSince Jul 1, 2021 Accepting new patients
Wellstreet Urgent Care of Michigan CurrentSince Jul 20, 2021 Accepting new patients
Flushing Urgent Care PLC CurrentSince Aug 5, 2020 Accepting new patients
Wellstreet Urgent Care of Michigan CurrentSince Sep 10, 2023 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

6020 W Pierson Rd
Flushing, MI 48433
Phone (810) 407-7989

18700 Mack Ave
Grosse Pointe Farms, MI 48236
Phone (313) 925-3486

3755 Fort St
Lincoln Park, MI 48146
Phone (313) 908-1941

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

Interoperability endpoints

  • Direct secure messaging: ceatmon7572@direct.hfhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1093284564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19179 MCCORMICK ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241017",
            "telephone_number": "313-605-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 MACK AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482362923",
            "telephone_number": "313-925-3486",
            "fax_number": "313-925-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATMON",
        "first_name": "CIARA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95010333",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "1093284564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ceatmon1@hfhs.org",
            "affiliation": "Y",
            "affiliationName": "Henry Ford Health System",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grosse Pointe Farms, MI

Sources for this page

Verify at the official NPI Registry.