Individual provider Active NPI

Juston N Mansfield, NP-C

  • Family Nurse Practitioner
  • Ferndale, MI
National Provider Identifier
1639675473
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704283237NSA18453 Issued in MI
Practice address
10300 W 8 Mile Rd
Ferndale, MI 48220-2100
Phone
(248) 398-3200
Fax
(248) 398-3200
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704283237NSA18453 MI Primary

Addresses

Primary practice location

10300 W 8 Mile Rd
Ferndale, MI 48220-2100

Mailing address

1546 Pearson St
Ferndale, MI 48220-1648
Phone (248) 721-7388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL, IA, GA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20180509001033 MI Practitioner - Nurse Practitioner 1153685623 Reassigns benefits to 2 organizations
I20220404001142 IL Practitioner - Nurse Practitioner 1153685623 Reassigns benefits to 1 organization
I20230123002173 IA Practitioner - Nurse Practitioner 1153685623
I20260213000478 GA Practitioner - Nurse Practitioner 1153685623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1546 Pearson St
Ferndale, MI 48220-1648

424 Church St
Nashville, TN 37219-2301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704283237NSA18453MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Dec 16, 2019 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Dec 16, 2019 Accepting new patients
Community Care Health Network LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684

4620 E 53rd St
Ste 200
Davenport, IA 52807
Phone (563) 213-5100

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1223 S Washington Ave
Royal Oak, MI 48067
Phone (248) 395-0080

28477 Hoover Rd
Warren, MI 48093
Phone (586) 250-4040

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Interoperability endpoints

  • Direct secure messaging: juston.manfield.1@19270.direct.athenahealth.com

Organizations & group practices 4

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1639675473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 PEARSON ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201648",
            "telephone_number": "248-721-7388",
            "fax_number": "313-543-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 W 8 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202100",
            "telephone_number": "248-398-3200",
            "fax_number": "248-398-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSFIELD",
        "first_name": "JUSTON",
        "middle_name": "N",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704283237NSA18453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.