Active NPI
Judy C Wheeler, NP
- Nurse Practitioner
- Farmington Hills, MI
National Provider Identifier
1679743322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704115137
- Practice address
- 28050 Grand River Ave
Farmington Hills, MI 48336-5919 - Phone
- (248) 471-8000
- NPI assigned
- Mar 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 4704115137 | MI | |
| Nurse Practitioner | 363L00000X | 4704115137 | MI | Primary |
Addresses
Primary practice location
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Mailing address
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1862
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4704115137 | MI | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1679743322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD",
"address_2": "STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849",
"telephone_number": "947-522-1862",
"fax_number": "947-522-0307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28050 GRAND RIVER AVE",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365919",
"telephone_number": "248-471-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "JUDY",
"middle_name": "C",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MI",
"license": "4704115137",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704115137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.