Cheryl Bombassei, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704206512 Issued in MI

Practice address

4100 John R St
Detroit, MI 48201-2013

Phone

(800) 527-6266

Fax

(313) 576-8699

NPI assigned

Jan 18, 2015

Last updated

Oct 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Cheryl Elsadr Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1421539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1144619826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "800-527-6266",
            "fax_number": "313-576-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266",
            "fax_number": "313-576-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBASSEI",
        "first_name": "CHERYL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-18",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704206512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "ELSADR",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Brian Julian Bomar, BSW, LLBSW
• Promise Bomide, MD
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• Valarie Bommarito, RRT
• Maanasa Bommineni
• Bon Voyage Transport

• Adult Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.