NPIMap

Individual provider Active NPI

Sherilyn Josephine Russell, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Grosse Pointe, MI
National Provider Identifier
1386859148
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301084057 Issued in MI
Practice address
22201 Moross Rd
Suite 252
Grosse Pointe, MI 48236-2169
Phone
(313) 343-4411
Fax
(313) 343-4412
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301084057 MI Primary
Internal Medicine Physician 207R00000X 4301084057 MI
Pediatrics Physician 208000000X 4301084057 MI

Addresses

Primary practice location

22201 Moross Rd
Suite 252
Grosse Pointe, MI 48236-2169

Mailing address

22201 Moross Rd
Suite 252
Grosse Pointe, MI 48236-2169
Phone (313) 343-4411

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
I20101130001325 MI Practitioner - EndocrinologyPractitioner - Internal Medicine 9436345543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Wayne State University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Cornerstone Medical GroupGroup PAC ID 7517162761, 65 clinicians

Practice addresses (Care Compare)

20229 E 9 Mile Rd
Saint Clair Shores, MI 48080-1775

4260 Van Dyke Rd
Suite 102
Almont, MI 48003-8546
Phone (810) 798-3994

43900 Garfield Rd
Suite 222
Clinton Township, MI 48038-1137
Phone (586) 286-0050

46591 Romeo Plank Rd
Macomb, MI 48044-5705

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301084057MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group CurrentSince Jan 1, 2016 Accepting new patients

Locations

4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

22201 Moross Rd
Ste 252
Grosse Pointe, MI 48236
Phone (313) 343-4411

46591 Romeo Plank Rd
Ste 131
Macomb, MI 48044
Phone (586) 226-6000

46591 Romeo Plank Rd
Ste 107
Macomb, MI 48044
Phone (586) 226-6080

20229 E 9 Mile Rd
#200
Saint Clair Shores, MI 48080
Phone (586) 267-0200

Interoperability endpoints

  • Direct secure messaging: sherilyn.russell.2@8209.direct.athenahealth.com
  • Direct secure messaging: srussell1149815@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

Organizations & group practices 1

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1386859148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "SUITE 252",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "313-343-4411",
            "fax_number": "313-343-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "SUITE 252",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "313-343-4411",
            "fax_number": "313-343-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SHERILYN",
        "middle_name": "JOSEPHINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301084057",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301084057",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301084057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe, MI

Sources for this page

Verify at the official NPI Registry.