Organization Active NPI

Donald C Austin MD PC

  • Neurological Surgery Physician
  • Mount Clemens, MI
National Provider Identifier
1003092966
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
DONALD C AUSTIN MD PC
Practice address
96 Northbound Gratiot Ave
Suite 102
Mount Clemens, MI 48043-2349
Phone
(586) 954-4677
Fax
(586) 954-4678
NPI assigned
Jan 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Donald C Austin, MD
Title
President
Phone
(586) 954-4677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

96 Northbound Gratiot Ave
Suite 102
Mount Clemens, MI 48043-2349

Mailing address

96 Northbound Gratiot Ave
Suite 102
Mount Clemens, MI 48043-2349
Phone (586) 954-4677

Other identifiers 4

IdentifierTypeStateIssuer
100141OtherMIGREAT LAKES HEALTH PLAN
1405021311OtherMIBLUE CROSS BLUE SHIELD
1039073MedicaidMI
21741OtherMIOMNICARE

National Provider Directory

National Provider Directory

Locations

4160 John R St
Ste 602
Detroit, MI 48201
Phone (313) 831-7993

96 Northbound Gratiot Ave
Ste 102
Mount Clemens, MI 48043
Phone (586) 954-4677

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1003092966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 NORTHBOUND GRATIOT AVE",
            "address_2": "SUITE 102",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432349",
            "telephone_number": "586-954-4677",
            "fax_number": "586-954-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 NORTHBOUND GRATIOT AVE",
            "address_2": "SUITE 102",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432349",
            "telephone_number": "586-954-4677",
            "fax_number": "586-954-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD C AUSTIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-954-4677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "100141",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1405021311",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1039073",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNICARE",
            "identifier": "21741",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.