Sherly C Jacob, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704210896 Issued in MI

Practice address

44201 Dequindre Road
Troy, MI 48085-1117

Phone

(248) 898-5000

NPI assigned

May 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Eastside Group LLCGroup PAC ID 4486790219, 36 clinicians

Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Eastside Group LLC

  • Anesthesiology Physician
  • Saint Clair Shores, MI
  • NPI 1235365289

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Michigan III PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Irving, TX
  • NPI 1972126209

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Northwestern Services, LLC

  • Certified Registered Nurse Anesthetist
  • Farmington Hills, MI
  • NPI 1215106679

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novi Aas LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1598176919
  Medicare reassignment NPD
• Superior Anesthetists Associates, Inc.

  • Specialist
  • Troy, MI
  • NPI 1831144518
  Medicare reassignment NPD
• West Michigan Aas LLC

  • Anesthesiology Physician
  • Novi, MI
  • NPI 1295149227
  Medicare reassignment NPD
• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northwestern Services, LLC

  • Anesthesiology Physician
  • Farmington Hills, MI
  • NPI 1083883649
  NPD
• William Beaumont Hospital

  dba Beaumont Hospital, Grosse Pointe

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  NPD

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

• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437108867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE ROAD",
            "address_2": "400 FSC - PCS",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-423-2481",
            "fax_number": "248-423-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE ROAD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-898-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SHERLY",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704210896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Mariam Jacob, PSYD
• Christy Jacob
• Maryconi M Jacob, MD
• Melanie A. Jacob, RD CSSD
• Shardai Jacob
• Mallory Jacober
• Christine Y Jacobson, RN CNM
• Sarah Jacquemain
• Neil Danial Jaddou, M.D.
• Aliraza Jaffer, MD

• Certified Registered Nurse Anesthetist in Troy, MI
• Providers in Troy, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.