Individual provider Active NPI

Elizabeth Sheep, PA-C

  • Physician Assistant
  • Ypsilanti, MI
National Provider Identifier
1619973104
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006047 Issued in MI
Practice address
5315 Elliott Drive
Suite 304
Ypsilanti, MI 48197-8634
Phone
(734) 712-0655
Fax
(734) 712-0611
NPI assigned
Jun 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006047 MI Primary

Addresses

Primary practice location

5315 Elliott Drive
Suite 304
Ypsilanti, MI 48197-8634

Mailing address

5315 Elliott Drive
Suite 304
Ypsilanti, MI 48197-8634
Phone (734) 712-0655

Other identifiers 3

IdentifierTypeStateIssuer
MA051813OtherPALICENSE
5601006047OtherMILICENSE
867633OtherPAMEDICARE GROUP #

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
I20110628000766 MI Practitioner - Physician Assistant 0042263964 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Mercy Livingston Hospital CurrentSince Mar 17, 2018 Accepting new patients
St Joseph Mercy Hospital Physician Assistant CurrentSince Nov 28, 2020 Accepting new patients
St Joseph Mercy Hospital CurrentSince Nov 28, 2020 Accepting new patients

Locations

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5315 Elliott Dr
Ste 304
Ypsilanti, MI 48197
Phone (734) 712-0655

Organizations & group practices 5

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1619973104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DRIVE",
            "address_2": "SUITE 304",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978634",
            "telephone_number": "734-712-0655",
            "fax_number": "734-712-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DRIVE",
            "address_2": "SUITE 304",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978634",
            "telephone_number": "734-712-0655",
            "fax_number": "734-712-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEP",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MA051813",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5601006047",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "867633",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.