NPIMap

Individual provider Active NPI

Carla Lee Justice, NP

  • Family Nurse Practitioner
  • Birmingham, MI
National Provider Identifier
1164401048
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704210139 Issued in MI
Practice address
1823 Humphrey Ave
Birmingham, MI 48009-7154
Phone
(248) 203-6330
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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 4704210139 MI Primary

Addresses

Primary practice location

1823 Humphrey Ave
Birmingham, MI 48009-7154

Mailing address

1823 Humphrey Ave
Birmingham, MI 48009-7154

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cjustice45746@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060911000164 MI Practitioner - Nurse Practitioner 5698779486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Oct 1, 2018 Accepting new patients
Cardiology and Vascular Associates PC Past Accepting new patients
Cardiology and Vascular Associates PC Nurse Practitioner Past Accepting new patients

Locations

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

468 Cadieux Rd
Grosse Pt Wds, MI 48230
Phone (313) 343-1000

3601 W 13 Mile Rd
Royal Oak, MI 48073

3601 W 13 Mile Rd
Fl 3
Royal Oak, MI 48073
Phone (248) 545-0070

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1164401048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 HUMPHREY AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 HUMPHREY AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097154",
            "telephone_number": "248-203-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "CARLA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704210139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjustice45746@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "1823 Humphrey Ave",
            "city": "Birmingham",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480097154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

Verify at the official NPI Registry.