Active NPI
Sheba Gustova Brooks, LPN
- Licensed Practical Nurse
- Southfield, MI
National Provider Identifier
1093981037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703096450
- Practice address
- 23588 Lee LN
Southfield, MI 48033-3101 - Phone
- (313) 447-7619
- NPI assigned
- Apr 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703096450 | MI | Primary |
Addresses
Primary practice location
23588 Lee LN
Southfield, MI 48033-3101
Mailing address
23588 Lee LN
Southfield, MI 48033-3101
Phone (313) 447-7619
Other names 1
- Mrs. Sheba Gustova Beaumont
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4703096450 | MI | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A-1 International Homecare, Inc. | Current | Accepting new patients |
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.
-
- Home Health Agency
- Clarkston, MI
- NPI 1326006370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1093981037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23588 LEE LN",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333101",
"telephone_number": "313-447-7619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23588 LEE LN",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333101",
"telephone_number": "313-447-7619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "SHEBA",
"middle_name": "GUSTOVA",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-30",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703096450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHEBA",
"last_name": "BEAUMONT",
"middle_name": "GUSTOVA",
"prefix": "MRS.",
"credential": "LPN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.