Individual provider Active NPI

Cheryl Marie Jusela, NP RN

  • Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1598950263
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704236063 Issued in MI
Practice address
3601 W 13 Mile Rd
William Beaumont Hospital
Royal Oak, MI 48073-6712
Phone
(248) 898-4021
Fax
(248) 898-1473
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704236063 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
William Beaumont Hospital
Royal Oak, MI 48073-6712

Mailing address

130 Town Center Dr Ste 203
Beaumont Medical Staff Affairs
Troy, MI 48084-1744
Phone (248) 585-8233

Other names 1

  • Ms. Cheryl Marie Harrison Former name

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
I20090224000070 MI Practitioner - Nurse Practitioner 8921163122 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704236063MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Apr 15, 2023 Accepting new patients
Vpa PC Current Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Apr 26, 2022 Accepting new patients
Vpa PC CurrentSince Apr 15, 2023 Accepting new patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner Past Accepting new patients

Locations

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1598950263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR STE 203",
            "address_2": "BEAUMONT MEDICAL STAFF AFFAIRS",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-585-8233",
            "fax_number": "248-585-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "WILLIAM BEAUMONT HOSPITAL",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-4021",
            "fax_number": "248-898-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSELA",
        "first_name": "CHERYL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704236063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "HARRISON",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.