Individual provider Active NPI

Cherisse M Peru, FNP

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1417598020
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4704294873 Issued in MI
Practice address
3960 Patient Care Dr
Lansing, MI 48911-4275
Phone
(517) 393-0352
Fax
(517) 393-0359
NPI assigned
Oct 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4704294873 MI Primary

Addresses

Primary practice location

3960 Patient Care Dr
Lansing, MI 48911-4275

Mailing address

3960 Patient Care Dr
Lansing, MI 48911-4275
Phone (517) 393-0352

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL jackson Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191219000265 MI Practitioner - Nurse Practitioner 9638486293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 E Michigan Ave
700 Sparrow Medical Group Nephrology
Lansing, MI 48912-1837
Phone (517) 364-5550

2601 Coolidge Rd
Suite B
East Lansing, MI 48823-6361
Phone (517) 253-4050

3960 Patient Care Dr
Suite 112
Lansing, MI 48911-4278
Phone (517) 393-0352

916 Mall Dr E
SMG Nephrology
Lansing, MI 48917-3125
Phone (517) 322-0894

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704294873MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association Nurse Practitioner CurrentSince Dec 1, 2019 Accepting new patients
Edward W Sparrow Hospital Association Family Medicine CurrentSince Dec 1, 2019 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

123 Lansing St
Charlotte, MI 48813
Phone (517) 543-2020

4530 S Hagadorn Rd
Ste A
East Lansing, MI 48823
Phone (517) 333-8414

2601 Coolidge Rd
Ste B
East Lansing, MI 48823
Phone (517) 253-4050

1676 Watertower Pl
Ste 700
East Lansing, MI 48823
Phone (517) 203-3998

2622 Heartland Blvd
Ionia, MI 48846
Phone (616) 522-0265

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1200 E Michigan Ave
Ste 500
Lansing, MI 48912
Phone (517) 364-5123

1200 E Michigan Ave
Ste 700
Lansing, MI 48912
Phone (517) 364-5888

2710 S Washington Ave
Lansing, MI 48910

916 Mall Dr E
Lansing, MI 48917
Phone (517) 322-0894

3960 Patient Care Dr
Ste 112
Lansing, MI 48911
Phone (517) 393-0352

300 Health Park Dr
Owosso, MI 48867
Phone (989) 627-7706

300 Health Park Dr
Ste 301
Owosso, MI 48867
Phone (989) 723-3613

901 S Oakland St
Ste 102
Saint Johns, MI 48879
Phone (989) 227-3435

975 E Townsend Rd
Saint Johns, MI 48879
Phone (989) 224-2662

901 S Oakland St
Saint Johns, MI 48879
Phone (517) 227-2338

49641 Grand River Ave
Wixom, MI 48393
Phone (248) 380-0515

Organizations & group practices 4

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 6

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": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1417598020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 PATIENT CARE DR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114275",
            "telephone_number": "517-393-0352",
            "fax_number": "517-393-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 PATIENT CARE DR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114275",
            "telephone_number": "517-393-0352",
            "fax_number": "517-393-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERU",
        "first_name": "CHERISSE",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4704294873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jackson",
            "affiliation": "N",
            "endpointDescription": "home",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5164 Stone River Rd",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492018187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.