Sheryl Lynn Shoebottom, ACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704181141 Issued in MI

Practice address

1000 Harrington St
Mount Clemens, MI 48043-2920

Phone

(586) 493-8000

NPI assigned

Jan 12, 2011

Last updated

Mar 13, 2017By 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

Other identifiers 1

Other names 1

• Sheryl Shoebottom Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
• Direct secure messaging: sshoebottom1151200@direct.hfhs.org

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.

• Henry Ford Health Macomb Oakland Hospital

  dba Henry Ford Warren Hospital

  • Nurse Practitioner
  • Warren, MI
  • NPI 1578696092
  Medicare reassignment NPD
• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Family Medicine Physician
  • Warren, MI
  • NPI 1134176472
  Medicare reassignment NPD
• Henry Ford Health Rochester Hospital

  • Nurse Practitioner
  • Rochester, MI
  • NPI 1427171511
  Medicare reassignment NPD
• McLaren Macomb

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1396014601
  Medicare reassignment NPD
• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD
• Henry Ford Health Rochester Hospital

  • Family Medicine Physician
  • Rochester, MI
  • NPI 1184747263
  NPD
• McLaren Macomb

  • General Acute Care Hospital
  • Mount Clemens, MI
  • NPI 1316938327
  NPD (past)

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1629373253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20855 BALINSKI DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385613",
            "telephone_number": "586-466-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEBOTTOM",
        "first_name": "SHERYL",
        "middle_name": "LYNN",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704181141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629373253",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERYL",
            "last_name": "SHOEBOTTOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alyssa Marie Shermetaro, DO
• Nicole Marie Shields, PA-C
• Tracy Shifflett, NP
• Kristina Nicole Shirley
• Yordanos Lakachew Shita, DO
• Shaesha Shoulders, LLMSW
• Peter Siclari, MD
• Seth Michael Signs, DO
• Alexandrea Simmons
• Claire Susan Simon, CRNA

• Acute Care Nurse Practitioner in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.