Individual provider Active NPI

Jessica Payton

  • Family Nurse Practitioner
  • West Bloomfield, MI
National Provider Identifier
1124403134
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704277904 Issued in MI
Practice address
7456 Arrowood Dr
West Bloomfield, MI 48324-2508
Phone
(248) 496-6666
NPI assigned
Jul 21, 2015
Last updated
Jul 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704277904 MI Primary

Addresses

Primary practice location

7456 Arrowood Dr
West Bloomfield, MI 48324-2508

Mailing address

7456 Arrowood Dr
West Bloomfield, MI 48324-2508

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
I20160224000546 MI Practitioner - Nurse Practitioner 4385949627 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704277904MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Botsford General Hospital CurrentSince Jan 21, 2016 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Nov 26, 2018 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Nov 26, 2018 Accepting new patients
Botsford General Hospital Current Accepting new patients
Botsford General Hospital CurrentSince Jan 21, 2016 Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

32754 Grand River Ave
Farmington Hls, MI 48336
Phone (248) 476-3280

20317 Farmington Rd
Livonia, MI 48152
Phone (248) 615-0777

15540 Beech Daly Rd
Redford, MI 48239
Phone (313) 387-5253

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.

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1124403134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7456 ARROWOOD DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483242508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7456 ARROWOOD DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483242508",
            "telephone_number": "248-496-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYTON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704277904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.