Nicole Flory Sansom

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704292912 Issued in MI

Practice address

3545 Aiden CT
Hudsonville, MI 49426-7736

Phone

(616) 780-3850

NPI assigned

Jul 20, 2019

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

Medicare fee-for-service enrollment

Enrolled in MI, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Match-E-Be-Nash-She-Wish Band of Pottawatomi IndiansGroup PAC ID 9133350952, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nsansom111888@direct.metrohealth.net

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.

• Match-E-Be-Nash-She-Wish Band of Pottawatomi Indians

  • Community Health Clinic/Center
  • Shelbyville, MI
  • NPI 1952685588

  TX

  Medicare reassignment Care Compare group NPD
• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD
• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  NPD (past)

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

• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation

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

{
    "created_epoch": "1563580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563580800000",
    "number": "1295388098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 AIDEN CT",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494267736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 AIDEN CT",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494267736",
            "telephone_number": "616-780-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSOM",
        "first_name": "NICOLE",
        "middle_name": "FLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-20",
        "last_updated": "2019-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704292912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaelin Marie Roberts
• Michael Scott Ruszkowski, D.D.S.
• Saint Mary'S Health Services
• Priscilla Salazar-Bont
• Emily Samuels, MA LPC
• Anca Stefania Santana, PA
• Benjamin Schell, DDS
• Carmen Schierbeek, PA-C
• Samuel Aaron Schlehuber
• Amber Cheyenne Schneider, LMSW

• Family Nurse Practitioner in Hudsonville, MI
• Providers in Hudsonville, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.