Sheri Lee Tack, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704253328 Issued in MI

Practice address

4069 Lake Dr SE Ste 312
Grand Rapids, MI 49546-8816

Phone

(616) 267-8700

NPI assigned

Jul 14, 2016

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

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Center of Branch CountyGroup PAC ID 9335037514, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health Home health agency, Troy, MI, CCN 237459
• Insight Hospital and Medical Center Coldwater Hospital, Coldwater, MI, CCN 230022
• Cameron Health Hospital, Angola, IN, CCN 151315

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Community Health Center of Branch County

  • General Practice Physician
  • Coldwater, MI
  • NPI 1124055009
  Medicare reassignment Care Compare group NPD
• Community Health Center of Branch County

  • Hematology & Oncology Physician
  • Coldwater, MI
  • NPI 1215964192
  NPD
• Community Health Center of Branch County

  • Internal Medicine Physician
  • Coldwater, MI
  • NPI 1306873286
  NPD
• Community Health Center of Branch County

  • Pediatric Adolescent Medicine Physician
  • Coldwater, MI
  • NPI 1619304458
  NPD
• Regio T Penna MD, PC

  • Specialist
  • Coldwater, MI
  • NPI 1245213537
  NPD
• Community Health Center of Branch County

  • Family Medicine Physician
  • Litchfield, MI
  • NPI 1518338359
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Health Center of Branch County

  • General Acute Care Hospital
  • Coldwater, MI
  • NPI 1063471639
  Care Compare affiliation
• Residential Home Health, LLC

  • Home Health Agency
  • Troy, MI
  • NPI 1992768550
  Care Compare affiliation
• Cameron Memorial Community Hospital, Inc.

  • Critical Access Hospital
  • Angola, IN
  • NPI 1386683316
  Care Compare affiliation

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1740633700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4069 LAKE DR SE STE 312",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468816",
            "telephone_number": "616-267-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACK",
        "first_name": "SHERI",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704253328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabletalk Counseling LLC
• Julie M Tabor, PT
• Kathryn Henrietta Tabor, MD
• Ted Tabor, CGC
• Daniel Taccolini
• Saturnius Tackett, D.D.S
• Hannah Prescott Taddie
• Yaineabeba D. Tadese
• Annabel Erika Tadic, PHARMD
• Allyson Tafelsky

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.