MS. MELISSA SUSAN BOOTHROYD (NPI# 1649356551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649356551 |
| Entity Type | Individual |
| Full Name | MS. MELISSA SUSAN BOOTHROYD |
| Credential | PNP |
| Practice Address |
23200 Ryan Rd Fitzgerald Health Center Warren MI 48091-4551 |
| Mailing Address |
29085 Oak Point Dr Farmington Hills MI 48331-2715 |
| Practice Telephone | 5867599070 |
| Mailing Telephone | 2484898632 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4704121618 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4667898 | 05 |
| Street Address |
23200 RYAN RD FITZGERALD HEALTH CENTER |
| City | WARREN |
| State | MI |
| Zip Code | 48091-4551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316171689 | Amy Kristin Totin | Social Worker | 23200 Ryan Rd, Warren, MI 48091-4551 | 2009-05-14 |
| 1962642389 | Kelly Faye Warner | Social Worker | 23200 Ryan Rd, Warren, MI 48091-4551 | 2009-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548615172 | Amanda Lynn Kelsey | Nurse Practitioner | 21647 Ryan Road, Warren, MI 48091 | 2016-05-02 |
| 1902284474 | Daejana Maldonado | Licensed Practical Nurse | 7519 Toepfer, Warren, MI 48091 | 2015-05-15 |
| 1245637743 | Jerami Roy | Recreation Therapist | 7086 E 9 Mile, Warren, MI 48091 | 2014-11-26 |
| 1265698344 | Amanda Sarah Yousif-mansour | Dentist | 2442 E 10 Mile Road, Warren, MI 48091 | 2008-07-29 |
| 1326171166 | Sunshine Dental Center PC | Dentist | 21761 Ryan Rd, Warren, MI 48091 | 2007-03-13 |
| 1487709630 | Albert Spickers | General Practice | 26193 Meredith Drive, Warren, MI 48091 | 2007-01-25 |
| 1487706859 | Rita Jean Rose | Physician Assistant | 2104 E. 11 Mile Road, Suite 600, Warren, MI 48091 | 2007-01-17 |
| 1790835452 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 2000 Ten Mile Rd., Warren, MI 48091 | 2007-01-12 |
| 1942363759 | Carolyn Joan Sucaet | Physical Therapist | 20952 12 Mile Road, Suite 110, St. Clair Shores, FM 48091 | 2006-12-19 |
| 1013070135 | Mcnichols Xray Clinic PC | Radiology | 21230 Dequindre Road, Southeast Michigan Surgical Hospital, Warren, MI 48091 | 2006-12-19 |
| Find all providers in zip 48091 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457756447 | Dawn Catherine Seifert | Nurse Practitioner | 29703 Hoover Rd, Warren, MI 48093-8901 | 2014-11-03 |
| 1225467509 | Jennifer Train | Nurse Practitioner | 30061 Schoenherr Rd, Warren, MI 48088-3133 | 2013-11-06 |
| 1225215619 | Susan Korb | Nurse Practitioner | 76 Stirling Rd, Suite 201, Warren, NJ 07059-5778 | 2008-01-28 |
| 1497932883 | Nancy H Montville | Nurse Practitioner | 76 Stirling Rd, Suite 201, Warren, NJ 07059-5778 | 2008-01-28 |
| 1396922787 | Kathleen Dempsey | Nurse Practitioner | 76 Stirling Rd, Suite 201, Warren, NJ 07059-5778 | 2008-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851991061 | Sarah Elizabeth Barber | Nurse Practitioner | 12918 Lake Point Pass, Van Buren Twp, MI 48111-2243 | 2020-10-27 |
| 1730700881 | Kelsey Olinik | Nurse Practitioner | 22200 Barclay Dr, Novi, MI 48374-3874 | 2020-04-29 |
| 1467080705 | Jessica Nicole Heichel | Nurse Practitioner | 7729 Brass Creek Ct, Dexter, MI 48130-9384 | 2020-03-31 |
| 1114550506 | Katlyn Roberts | Nurse Practitioner | 60160 E 8 Mile Rd, South Lyon, MI 48178-9768 | 2020-02-13 |
| 1093351595 | Emily Janina Jamett | Nurse Practitioner | 31815 Southfield Rd Ste 10, Beverly Hills, MI 48025-5471 | 2019-11-20 |
| 1508410747 | Clorissa Diedrich | Nurse Practitioner | 829 N Center Ave Ste 130, Gaylord, MI 49735-1684 | 2019-07-25 |
| 1255895355 | Jessica Lynn Kata | Nurse Practitioner | 19229 Mack Ave Ste 28, Grosse Pointe Woods, MI 48236-2857 | 2019-01-23 |
| 1467934679 | Anita Lynn Riddle | Nurse Practitioner | 100 W. Vanburen Street, Battle Creek, MI 49017 | 2018-09-04 |
| 1285120634 | Alexandra Danko | Nurse Practitioner | 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 | 2018-07-09 |
| 1417442617 | Shelby Fredricks | Nurse Practitioner | 1205 S Mission St Ste 4, Mount Pleasant, MI 48858-3939 | 2018-06-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.