Jennifer Lynn Pelshaw

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704281499 Issued in MI

Practice address

18525 Millar Rd
Clinton Township, MI 48036-2093

Phone

(586) 703-3704

NPI assigned

Aug 22, 2016

Last updated

Aug 22, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• VHS Physicians of Michigan

  dba DMC Medical Group

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  Medicare reassignment NPD

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1316492283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18525 MILLAR RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362093",
            "telephone_number": "586-703-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18525 MILLAR RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362093",
            "telephone_number": "586-703-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELSHAW",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704281499",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704281499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gage Peavler, LMSW
• Andrew R Peleman, DO
• Rene Richard Peleman, MD
• Sandy Pelini, LLPC, NCC
• Sarah Pellerito
• Christine Peltier
• Judith Kay Peltier, MA, LLP
• Kayla Penner
• Corey Richard Perkins, IDC
• Dawn Perkins

• Family Nurse Practitioner in Clinton Township, MI
• Providers in Clinton Township, 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 Aug 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.