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).
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
3200 W Centre Ave, Suite 203, Portage, MI 490244889 | 2693240799 | 2693248013 |
Street Address |
2093 HEALTH DR SW STE 100 |
City | WYOMING |
State | MI |
Zip Code | 49519 |
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 |
Find all providers in zip 49519 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
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 |
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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.