ASCENSION PROVIDENCE HOSPITAL (NPI# 1619932670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619932670 |
| Entity Type | Organization |
| Organization Name | ASCENSION PROVIDENCE HOSPITAL |
| Other Organization Name | PH PSYCHIATRY MD/PROVIDENCE HOSPITAL AND MEDICAL CENTERS INC |
| Practice Address |
16001 W 9 Mile Rd Physician Billing Services Southfield MI 48075-4818 |
| Mailing Address |
2800 Livernois Rd Suite 500 Troy MI 48083-1215 |
| Practice Telephone | 2488493000 |
| Practice Fax Number | 2488492244 |
| Mailing Telephone | 2486808000 |
| Mailing Fax Number | 2486808032 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2018-12-04 |
| Authorized Official Name | SARAH STARKEL (CREDENTAILING COORDINATOR) |
| Authorized Official Telephone | 2486808121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MI BLUE CROSS GROUP PIN # | 260F364900 | 01 |
| Other Name | Type Code |
|---|---|
| PH Psychiatry MD/Providence Hospital and Medical Centers Inc | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225093776 | Ascension Providence Hospital | Nuclear Medicine | 2800 Livernois Rd, Blgd D Suite 500, Troy, MI 48083-1215 | 2006-04-19 |
| 1003892092 | Ascension Providence Hospital | Psychiatric Unit | 16001 W. 9 Mile Road, Southfield, MI 48075-4818 | 2005-12-21 |
| 1043385909 | Ascension Providence Hospital | General Acute Care Hospital | 47601 Grand River Ave, Novi, MI 48374-1233 | 2006-11-22 |
| 1851339196 | Ascension Providence Hospital | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-06-02 |
| 1003871062 | Ascension Providence Hospital | Pediatrics | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1629033683 | Ascension Providence Hospital | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1265497226 | Ascension Providence Hospital | Pediatrics | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1528023587 | Ascension Providence Hospital | Psychologist | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1235194291 | Ascension Providence Hospital | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1144285107 | Ascension Providence Hospital | General Practice | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| Street Address |
16001 W 9 MILE RD PHYSICIAN BILLING SERVICES |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-4818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929338 | Sally Rae Arbuckle | Registered Nurse | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2005-06-01 |
| 1730780651 | Jennifer Bekes | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-11-06 |
| 1497361133 | Matthew Hoffman | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-09-18 |
| 1447866215 | Marisa Mcalister | Nurse Practitioner | 16001 W 9 Mile Rd, Southfield, MI 48075-4803 | 2020-09-17 |
| 1629682935 | John Michael Faraj | Registered Nurse | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-09-03 |
| 1861017337 | Adnan Basheer | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-10 |
| 1891319885 | Seti Kelemework Belay | Radiology | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-04 |
| 1467076851 | Alexa Rae Arvidson | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-02 |
| 1275157638 | Angela Niezgoda | Obstetrics & Gynecology | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-02 |
| 1942824453 | Marc Thomas Zughaib | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083247134 | Actify Neurotherapies, Pllc | Psychiatry & Neurology | 28475 Greenfield Rd Ste 113, Southfield, MI 48076-3034 | 2020-02-18 |
| 1306225487 | Centre Hrw Inc | Psychiatry & Neurology | 23725 Northwestern Hwy, Southfield, MI 48075-3338 | 2015-05-22 |
| 1811287584 | Samreen Shah | Psychiatry & Neurology | Ascension Providence Hospital, 16001 W Nine Mile Road, Southfield, MI 48075 | 2011-04-14 |
| 1134449176 | Sankofa Healthcare Services | Psychiatry & Neurology | 22690 Rougemont Dr, Southfield, MI 48033-5963 | 2010-06-01 |
| 1447461603 | Barbara Kilian, M D | Psychiatry & Neurology | 29260 Franklin Rd Apt 109, Southfield, MI 48034-1144 | 2007-05-26 |
| 1689895518 | Richard Allen Ruzumna | Psychiatry & Neurology | 29260 Franklin, #104, Southfield, MI 48034 | 2007-05-01 |
| 1114062262 | Michael Freedman | Psychiatry & Neurology | 24725 W 12 Mile Rd Ste 310, Southfield, MI 48034-8337 | 2007-02-20 |
| 1174667935 | Romulo S. Ancog Md PC | Psychiatry & Neurology | 15700 W 10 Mile Rd, Suite 107, Southfield, MI 48075-2149 | 2007-02-16 |
| 1275671968 | Northwestern Psychiatry & Counseling Center PC | Psychiatry & Neurology | 26699 W 12 Mile Rd Ste 100, Southfield, MI 48034-1578 | 2007-02-02 |
| 1174674824 | Gloria Pitts | Psychiatry & Neurology | 15659 W 10 Mile Rd, Southfield, MI 48075-2188 | 2007-01-16 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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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.