MICHELE JOANN ROACH (NPI# 1265647200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265647200 |
| Entity Type | Individual |
| Full Name | MICHELE JOANN ROACH |
| Practice Address |
2799 W Grand Blvd Detroit MI 48202-2608 |
| Mailing Address |
18311 Cedar Island Blvd Brownstown MI 48174-9585 |
| Practice Telephone | 3139161231 |
| Mailing Telephone | 3139950551 |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
3701-0106-0953-5 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | CERTIFIED PHARMACY TECH | 3701-0106-0953-552 | 01 |
| Street Address |
2799 W GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48202-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235132069 | Donna Prince | Radiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2005-05-24 |
| 1790386704 | Alexandria L Blevins | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-05 |
| 1255932430 | Amy Katlyn Carion | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-11-04 | |
| 1871194415 | Alexandria Denise Roberts | Physical Therapist | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-11-02 |
| 1174121420 | John Charles Sanno | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2020-10-09 |
| 1932706991 | Fallon J Awe | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-02 |
| 1922615145 | Chelsea Elizabeth Owen | Nurse Anesthetist, Certified Registered | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1275130395 | Zana Latkovac | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-10-01 |
| 1487260030 | Jessica Lee Moret | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-18 |
| 1932713237 | Lucas Costa Santos | Anesthesiology | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821307620 | Life & Destiny Builders | Clinic/Center | 19400 Joy Rd, Detroit, MI 48228-3035 | 2010-09-28 |
| 1154620532 | Vanessa Cuevas | Clinic/Center | 4880 Lawndale St, Detroit, MI 48210-2010 | 2011-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1093365835 | Sacred Heart Rehabilitation Center | Clinic/Center | 22256 Marine Ave, Eastpointe, MI 48021-2634 | 2019-09-13 |
| 1124677265 | Sacred Heart Rehabilitation Center | Clinic/Center | 23099 David Ave, Eastpointe, MI 48021-1826 | 2019-09-11 |
| 1699324731 | Sacred Heart Rehabilitation Center | Clinic/Center | 1504 E Greig Ave, Madison Heights, MI 48071-3826 | 2019-09-11 |
| 1851958706 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd., D - 5, Community Health, Southfield, MI 48033 | 2019-05-28 |
| 1376100479 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd, D - 5, Community Health, Southfield, MI 48033-3849 | 2019-05-23 |
| 1396302857 | William Beaumont Hospital | Clinic/Center | Beaumont Service Center, 26901 Beaumont Blvd, Community Health, D - 5, Southfield, MI 48033 | 2019-05-21 |
| 1700442597 | Botsford General Hospital | Clinic/Center | 26901 Beaumont Blvd, Beaumont Service Center, Community Health, D - 5, Southfield, MI 48033 | 2019-05-16 |
| 1013410596 | Our Wellness Hub | Clinic/Center | 17401 E 10 Mile Rd, Eastpointe, MI 48021-1256 | 2018-03-12 |
| 1235648700 | Sacred Heart Rehabilitation Center | Clinic/Center | 329 Butternut St, Benton Harbor, MI 49022-2922 | 2017-09-27 |
| 1326427162 | Holistic Healer & Wellness Center Inc | Clinic/Center | 3998 Clippert St, Dearborn Hts, MI 48125-2731 | 2015-05-27 |
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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.