Individual provider Active NPI

Chinyere Mercy Mbamah, FNP-C

  • Primary Care Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1851855845
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704197641 Issued in MI
Practice address
24111 Southfield Rd
Southfield, MI 48075-2841
Phone
(248) 557-8800
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704197641 MI Primary

Addresses

Primary practice location

24111 Southfield Rd
Southfield, MI 48075-2841

Mailing address

28110 Rollcrest Rd
Farmington Hills, MI 48334-4018
Phone (248) 579-3051

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
I20190410000646 MI Practitioner - Nurse Practitioner 7012258585 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Livewell Medical Group PLLCGroup PAC ID 0042667529, 9 clinicians

Practice addresses (Care Compare)

24831 Ryan Rd
Warren, MI 48091-3390
Phone (586) 619-7689

Merit-based Incentive Payment System (MIPS)

Final score
21.81 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704197641MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Livewell Medical Group PLLC CurrentSince Dec 28, 2025 Accepting new patients
Wound Care Solutions PLLC CurrentSince May 3, 2025 Accepting new patients

Locations

3611 Carpenter St
Ste 5
Hamtramck, MI 48212
Phone (313) 733-8286

2838 E Long Lake Rd
Ste 246
Troy, MI 48085
Phone (313) 312-3932

24831 Ryan Rd
Warren, MI 48091
Phone (586) 486-5037

Organizations & group practices 2

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": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1851855845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28110 ROLLCREST RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344018",
            "telephone_number": "248-579-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24111 SOUTHFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752841",
            "telephone_number": "248-557-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAMAH",
        "first_name": "CHINYERE",
        "middle_name": "MERCY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704197641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.