Michelle K Justus, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704195306 Issued in MI

Practice address

5629 Stadium Dr
Kalamazoo, MI 49009-1952

Phone

(269) 372-1000

Fax

(269) 372-0698

NPI assigned

Jan 25, 2006

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 identifiers 1

Other names 1

• Michelle K Jepsen Former name

Electronic endpoints 1

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

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.

• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1336119809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5629 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091952",
            "telephone_number": "269-372-1000",
            "fax_number": "269-372-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5629 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091952",
            "telephone_number": "269-372-1000",
            "fax_number": "269-372-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTUS",
        "first_name": "MICHELLE",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704195306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4486060",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "JEPSEN",
            "middle_name": "K",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karlee Junkins, OTR/L
• Amy Juodawlkis, PA-C
• Just Like Home Afc LLC
• Amy Elizabeth Justa, PA-C
• Allison Justice
• Jwala K C, MD
• K Valley Orthopedics PC
• K Valley Orthopedics PC
• Gael Glenn Kabell, MD
• Jessica Eileen Kaczmarczyk, LMSW

• Pediatric Nurse Practitioner in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.