Nussdorfercnp LLC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

Legal business name

NUSSDORFERCNP LLC

Practice address

806 Hogsback Rd Ste C
Mason, MI 48854-8525

Phone

(517) 213-8419

NPI assigned

Dec 1, 2022

Last updated

Apr 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Beth Houpt

Title

Credentialing

Phone

(517) 676-9797

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shari A Nussdorfer, C.N.P.

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Mason, MI
  • NPI 1093828030

  Psychiatric/Mental Health, Adult

  Medicare reassignment NPD

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1871203703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 HOGSBACK RD STE C",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488548525",
            "telephone_number": "517-213-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUSSDORFERCNP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-01",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9797"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Nisse
• Howard Nitz III, MSW
• Joshua Esinwoke Nnanji, MD
• Claire Nussdorfer
• Shari A Nussdorfer, C.N.P.
• Debra Ann O'Berry, MA, LPC, CAAC
• Lynette O'Connor, N.P.
• Amy J. Odom, DO
• Odyssey Healthcare Holding Company (Heartland)
• Raeann Olger, LLMSW

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Mason, MI
• Providers in Mason, MI by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.