SHERRILL D BUSBOOM


Address: 2093 Health Dr Sw Ste 100, Wyoming, MI 49519
Phone: 6162527264

SHERRILL D BUSBOOM (NPI# 1720046626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720046626
Entity Type Individual
Full Name SHERRILL D BUSBOOM
Credential PA
Practice Address 2093 Health Dr Sw Ste 100
Wyoming
MI 49519
Mailing Address 5900 Byron Center Ave Sw
Medical Administration
Wyoming
MI 49519-9606
Practice Telephone 6162527264
Practice Fax Number 6162526977
Mailing Telephone 6162523243
Mailing Fax Number 6162520260
Enumeration Date 2006-05-02
Last Update Date 2018-07-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363A00000X Physician Assistant 5601001603 MI Physician Assistants & Advanced Practice Nursing Providers
Y 363AM0700X Physician Assistant
Specialization: Medical
5601001603 MI Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
3200 W Centre Ave, Suite 203, Portage, MI 490244889 2693240799 2693248013

Office Location

Street Address 2093 HEALTH DR SW STE 100
City WYOMING
State MI
Zip Code 49519

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1609364009 Alexandra K Hylen Dentist 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 2018-05-01
1962925685 Nicole Lee Kolasa Rehabilitation Counselor 2038 Melvin St. Sw, Wyoming, MI 49519 2017-07-25
1720534472 Michael Ash Rehabilitation Practitioner 1870 36th Street, Wyoming, MI 49519 2016-08-31
1891248993 Kayleigh Saucier Family Medicine 5900 Byron Center Avenue Se, Wyoming, MI 49519 2016-07-26
1093112799 Wmro LLC Radiology 5950 Metro Way, Wyoming, MI 49519 2014-11-24
1033547658 Maranda Catherine Gary Nurse Practitioner 2122 Health Drive, Wyoming, MI 49519 2013-10-16
1144657800 Diana Ro Psychologist 4211 Parkway Place Sw, #100, Wyoming, MI 49519 2013-09-26
1386077873 Lindsey Elizabeth Chorney Nurse Practitioner 2122 Health Drive Sw, Suite 133, Wyoming, MI 49519 2013-08-20
1124377163 Vision and Sensory Center of Michigan LLC Optometrist 4467 Byron Center Ave., Wyoming, MI 49519 2012-09-06
1881940203 Judah Durable Medical Equipment & Medical Supplies 2975 Waterchase Way Sw Suite 307, Wyoming, MI 49519 2012-08-03
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659735272 Jason Michael Harp Physician Assistant 304 44th St Sw, Wyoming, MI 49548-4108 2016-04-09
1427058015 John G Lepisto Jr. Physician Assistant 5251 Clyde Park Ave Sw, Wyoming, MI 49509-9522 2005-07-26
1215937198 Barbara L Duchemin Physician Assistant 5251 Clyde Park Sw, Wyoming, MI 49509 2005-07-21
1659937381 Daniel James Devries Physician Assistant 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 2019-05-17
1861888620 Claire Timm Hughes Physician Assistant 5200 Fairview Blvd, Wyoming, MN 55092-8013 2015-04-08
1063812782 Randall Walters Physician Assistant 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 2014-08-29
1649438516 Richard Gordon Nellis Physician Assistant 5200 Fairview Blvd, Wyoming, MN 55092-8013 2008-05-28
1942376165 Lori J Tatay Physician Assistant 2122 Health Dr Sw, Wyoming, MI 49519-9698 2006-11-28
1417967217 Leandra K Sebald Physician Assistant 5900 Byron Center Ave Sw, Wyoming, MI 49519 2006-08-08
1932118700 Christine A Genther Physician Assistant 5900 Byron Center Ave Sw, Wyoming, MI 49519 2006-08-07
Find all providers in WYOMING

Competitor

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City WYOMING
Zip Code 49519

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Dataset Information

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.

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