Individual provider Active NPI

Sherry Simpson, ANP-BC

  • Adult Health Nurse Practitioner
  • Saint Joseph, MI
National Provider Identifier
1962819763
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704209159 Issued in MI
Practice address
2900 Lakeview Ave
Saint Joseph, MI 49085-2379
Phone
(269) 449-5316
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704209159 MI Primary

Addresses

Primary practice location

2900 Lakeview Ave
Saint Joseph, MI 49085-2379

Mailing address

2900 Lakeview Ave
Saint Joseph, MI 49085-2379
Phone (269) 449-5316

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
I20040819000947 MI Practitioner - Nurse Practitioner 4385617075 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704209159MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Dec 20, 2020 Accepting new patients
Lakeland Medical Practices CurrentSince Dec 20, 2020 Accepting new patients

Locations

6416 Deans Hill Rd
Berrien Ctr, MI 49102
Phone (269) 471-7741

9625 Red Arrow Hwy
Bridgman, MI 49106
Phone (269) 465-6050

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1962819763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LAKEVIEW AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852379",
            "telephone_number": "269-449-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LAKEVIEW AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852379",
            "telephone_number": "269-449-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "SHERRY",
        "credential": "ANP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704209159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.