Individual provider Active NPI

Sheeba Shajan John, AGACNP

  • Acute Care Nurse Practitioner
  • Livonia, MI
National Provider Identifier
1720482839
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704247571 Issued in MI
Practice address
36123 Schoolcraft Rd
Livonia, MI 48150-1216
Phone
(734) 464-0887
Fax
(734) 402-0254
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704247571 MI Primary

Addresses

Primary practice location

36123 Schoolcraft Rd
Livonia, MI 48150-1216

Mailing address

36123 Schoolcraft Rd
Livonia, MI 48150-1216
Phone (734) 464-0887

Other names 1

  • Sheeba Baby 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
I20150202001010 MI Practitioner - Nurse Practitioner 9638494248 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health Macomb Oakland HospitalGroup PAC ID 7315859725, shared by 8 NPIs, 155 clinicians

Practice addresses (Care Compare)

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Dec 1, 2017 Accepting new patients
Inpatient Consultants of Michigan PC CurrentSince Feb 1, 2015 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Nurse Practitioner CurrentSince Feb 1, 2018 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Dec 1, 2017 Accepting new patients

Locations

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

36123 Schoolcraft Rd
Livonia, MI 48150
Phone (734) 793-6140

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: sjohn316729@direct.hfhs.org

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": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1720482839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "SHEEBA",
        "middle_name": "SHAJAN",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704247571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEEBA",
            "last_name": "BABY",
            "credential": "RN, NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.