Individual provider Active NPI

Juliana Mwose, APRN

  • Nurse Practitioner
  • Novi, MI
National Provider Identifier
1134424708
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704345741 Issued in IN
Practice address
41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818
Phone
(248) 660-1220
NPI assigned
Jan 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 2009006407 IN
Nurse Practitioner 363L00000X 4704345741 IN Primary
Registered Nurse 163W00000X 28144705A IN

Addresses

Primary practice location

41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818

Mailing address

3212 Hickory Rd Ste B
Mishawaka, IN 46545-8863
Phone (574) 251-0498

Other practice location 1

3212 Hickory Rd Ste B
Mishawaka, IN 46545-8863
Phone (574) 251-0498

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
I20241203001341 MI Practitioner - Nurse Practitioner 3476731993 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

1211 Stateline Rd
Niles, MI 49120-4729
Phone (269) 684-2810

Hospital & facility affiliations

  • Ascension Borgess Lee Hospital Hospital, Dowagiac, MI, CCN 231315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28144705AINMDRegistered Nurse
4704345741INMDNurse Practitioner
2009006407INMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest H PLLC CurrentSince Aug 31, 2025 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Sep 23, 2024 Accepting new patients
William E Paul DDS PC PastSince Oct 26, 2010 Accepting new patients

Locations

811 E 12th St
Mishawaka, IN 46544
Phone (574) 249-1917

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

55432 Colby St
Dowagiac, MI 49047
Phone (269) 330-6414

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

1211 Stateline Rd
Niles, MI 49120
Phone (269) 684-2810

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1134424708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 HICKORY RD STE B",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458863",
            "telephone_number": "574-251-0498",
            "fax_number": "574-251-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 109",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "248-660-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3212 Hickory Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465458863",
            "country_code": "US",
            "telephone_number": "574-251-0498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWOSE",
        "first_name": "JULIANA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IN",
            "license": "2009006407",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "4704345741",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28144705A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.