DETROIT MEDICAL CENTER (NPI# 1619332574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619332574 |
| Entity Type | Organization |
| Organization Name | DETROIT MEDICAL CENTER |
| Other Organization Name | CHILDREN'S HOSPITAL OF MI |
| Practice Address |
43205 Creekview Dr Canton MI 48187-3049 |
| Practice Telephone | 7348447241 |
| Mailing Telephone | 7348447241 |
| Enumeration Date | 2015-12-19 |
| Last Update Date | 2015-12-19 |
| Authorized Official Name | MS. TRACEY ALLENE TYUS-BAILEY (CLINICAL SOCIAL WORKER) |
| Authorized Official Telephone | 3137455281 |
| Authorized Official Credential | LMSW |
| Is Organization Subpart | Y |
| Parent Organization Name | TENENT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
6801067466 | MI | Ambulatory Health Care Facilities |
| N | 282N00000X | General Acute Care Hospital | 6801067466 | MI | Hospitals |
| Y | 282NC2000X |
General Acute Care Hospital Specialization: Children |
6801067466 | MI | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MICHIGAN LICENSE NUMBER | 6801067466 | 01 |
| Other Name | Type Code |
|---|---|
| Children's Hospital of MI | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154365 | Detroit Medical Center | General Acute Care Hospital | 4713 Pond Run, Canton, MI 48188-2196 | 2016-10-10 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1326279803 | Detroit Medical Center | Special Hospital | 39180 Citation Pl, Apt # 35104, Farmington Hills, MI 48331-4901 | 2009-08-02 |
| 1356510085 | Detroit Medical Center | Clinic/Center | 4201 Saint Antoine St Ste 2e, Detroit, MI 48201-2153 | 2008-02-27 |
| 1699327429 | Detroit Medical Center | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2019-07-11 |
| 1205178761 | Detroit Medical Center | Psychiatry & Neurology | 3901 Beaubien St, Department of Neurology, Children's Hospital of Michiga, Detroit, MI 48201-2119 | 2013-03-22 |
| 1346508157 | Detroit Medical Center | Special Hospital | 4160 John R St, Detroit, MI 48201-2020 | 2012-04-30 |
| 1770853251 | Detroit Medical Center | Emergency Medicine | 6071 W Outer Dr, Emergency Medicine Department, Detroit, MI 48235-2624 | 2011-12-30 |
| 1770869257 | Detroit Medical Center | Physician Assistant | 4201 Saint Antoine St Ste 6a, Drh University Health Center, Detroit, MI 48201-2153 | 2011-10-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DETROIT MEDICAL CENTER | 3990 John R St, Detroit, MI 48201-2018 |
| Street Address |
43205 CREEKVIEW DR |
| City | CANTON |
| State | MI |
| Zip Code | 48187-3049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114547874 | Savannah Dugan | Occupational Therapist | 5969 N Canton Center Rd, Canton, MI 48187 | 2020-04-23 |
| 1225674823 | Cura Professional Group | Home Health | 1638 East Lakeview Lane, Canton, MI 48187 | 2019-11-19 |
| 1740825207 | Vlp Can LLC | Dentist | 39883 Ford Rd., Canton, MI 48187 | 2019-11-08 |
| 1487112942 | Michigan Dialysis Services, LLC | Clinic/Center | 275 N Canton Center Rd, Canton, MI 48187 | 2019-03-04 |
| 1447734496 | Integrated Health Pharmacy LLC | Pharmacy | 49650 Cherry Hill Rd., Canton, MI 48187 | 2018-09-16 |
| 1285117499 | Susan Rhoton | Licensed Vocational Nurse | 6223 N Canton, Suite 201, Canton, MI 48187 | 2018-09-13 |
| 1285110767 | Personalized Nursing Light House Inc | Substance Abuse Rehabilitation Facility | 7752 N Canton Center Rd Ste 120, Canton, MI 48187 | 2018-07-17 |
| 1083111793 | Heydie Alejandra Orr | Social Worker | 5840 N Canton Center Rd Ste 221, Canton, MI 48187 | 2018-04-09 |
| 1285139204 | Chawla Enterprises Inc | Durable Medical Equipment & Medical Supplies | 5840 N Canton Center Rd Ste 222, Canton, MI 48187 | 2018-03-30 |
| 1689192221 | Arcturus Pllc | Physical Therapist | 5820 Lilley Rd. Suite 6, Canton, MI 48187 | 2017-09-04 |
| Find all providers in zip 48187 | ||||
| Taxonomy Code | 282NC2000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Children |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447616354 | Childrens Hospital of Michigan | General Acute Care Hospital | 16197 Ohio St, Detroit, MI 48221-2953 | 2016-01-07 |
| 1508010760 | Children Hosptial of Michigan | General Acute Care Hospital | 3737 Beaubien St Apt 805, Detroit, MI 48201-2152 | 2008-11-13 |
| 1700241072 | Children's Hospital of Michigan | General Acute Care Hospital | 4201 Saint Antoine St, University Health Center, Suite 4b, Detroit, MI 48201-2153 | 2015-12-30 |
| 1851776876 | Jennifer Ha | General Acute Care Hospital | 1540 E Hospital Dr, Department of Pediatrics Otolaryngology, Ann Arbor, MI 48109-4000 | 2015-07-21 |
| 1396162350 | University of Michgan Health System | General Acute Care Hospital | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-03-27 |
| 1518216787 | Children's Hospital of Michigan | General Acute Care Hospital | 3901 Beaubien, Detroit, MI 48201 | 2012-09-04 |
| 1902108673 | Spectrum Health Hospitals | General Acute Care Hospital | 330 Barclay Ave Ne, Grand Rapids, MI 49503-2556 | 2010-12-01 |
| 1730492661 | Grand Rapids Medical Education Partners | General Acute Care Hospital | 100 Michigan St Ne # 13, Grand Rapids, MI 49503-2560 | 2010-07-20 |
| 1598996480 | Grand Rapids Medical Education and Research Number | General Acute Care Hospital | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2009-07-27 |
| 1558519827 | Children's Hospital of Michigan, Detroit Medical Center | General Acute Care Hospital | 3901 Beaubien St, Children's Hospital of Michigan, Detroit, MI 48201-2119 | 2008-08-28 |
| 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.