Individual provider Active NPI

Sherry Headley, NP

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1972907368
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704358153 Issued in MI
Practice address
4350 Jackson Rd Ste 200
Ann Arbor, MI 48103-1889
Phone
(734) 761-2581
Fax
(734) 761-9540
NPI assigned
Oct 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 023487 OH
Family Nurse Practitioner 363LF0000X 71005146A IN
Nurse Practitioner 363L00000X 4704358153 MI Primary

Addresses

Primary practice location

4350 Jackson Rd Ste 200
Ann Arbor, MI 48103-1889

Mailing address

24 Frank Lloyd Wright Dr Lbby J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

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
I20200402001325 MI Practitioner - Nurse Practitioner 1153543087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

11775 Tecumseh Clinton Rd
Clinton, MI 49236-9541
Phone (517) 456-7449

Hospital & facility affiliations

  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704358153MIMDNurse Practitioner
023487OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Apr 1, 2020 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation CurrentSince Apr 1, 2020 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

4350 Jackson Rd
Ste 200
Ann Arbor, MI 48103
Phone (734) 761-2581

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

3200 W Liberty Rd
Ste C
Ann Arbor, MI 48103
Phone (734) 761-2581

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

11775 Tecumseh Clinton Rd
Clinton, MI 49236
Phone (517) 456-4171

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Interoperability endpoints

  • Direct secure messaging: ssausaman640932@direct.trinity-health.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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1972907368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR LBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 JACKSON RD STE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481031889",
            "telephone_number": "734-761-2581",
            "fax_number": "734-761-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADLEY",
        "first_name": "SHERRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "023487",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005146A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704358153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.