Individual provider Active NPI

Cassandra Meghann Bunker, NP-C

  • Nurse Practitioner
  • Troy, MI
National Provider Identifier
1487153367
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704297171 Issued in MI
Practice address
44199 Dequindre Rd Ste 615
Troy, MI 48085-1128
Phone
(248) 964-9660
NPI assigned
Feb 7, 2018
Last updated
Jul 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 382948 NY
Nurse Practitioner 363L00000X 4704297171 MI Primary

Addresses

Primary practice location

44199 Dequindre Rd Ste 615
Troy, MI 48085-1128

Mailing address

2690 Dashwood Dr
Troy, MI 48083-4401
Phone (248) 227-1460

Other practice location 1

3229 E Genesee St
Syracuse, NY 13214-2040
Phone (315) 464-5726

Other practice location 2

17900 23 Mile Rd Ste 101
Macomb, MI 48044-1161
Phone (586) 868-9010

Other practice location 3

22201 Moross Rd Ste 270
Detroit, MI 48236-2175
Phone (313) 343-3809

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cbunker5997719@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704297171MIMDNurse Practitioner
382948NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
William Beaumont Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cbunker1227321@epic00.shdirect.org
  • Direct secure messaging: cbunker5997719@direct.beaumont.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1487153367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 DASHWOOD DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480834401",
            "telephone_number": "248-227-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE RD STE 615",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851128",
            "telephone_number": "248-964-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3229 E Genesee St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132142040",
            "country_code": "US",
            "telephone_number": "315-464-5726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17900 23 Mile Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "MI",
            "postal_code": "480441161",
            "country_code": "US",
            "telephone_number": "586-868-9010",
            "fax_number": "586-868-9015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22201 Moross Rd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362175",
            "country_code": "US",
            "telephone_number": "313-343-3809",
            "fax_number": "313-417-0560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNKER",
        "first_name": "CASSANDRA",
        "middle_name": "MEGHANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "382948",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704297171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbunker5997719@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44199 Dequindre Rd Ste 615",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.