Active NPI
Gary Matthew Balian, MD
- Psychiatry Physician
- Lapeer, MI
National Provider Identifier
1013022920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301053578
- Practice address
- 1254 N Main St
Lapeer, MI 48446-1343 - Phone
- (810) 664-4531
- Fax
- (810) 667-7337
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301053578 | MI | Primary |
Addresses
Primary practice location
1254 N Main St
Lapeer, MI 48446-1343
Mailing address
401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11426625 | Other | MI | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 804 | WY | MD | General Practice Dentistry |
| 4301053578 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Center | Past | Accepting new patients | |
| Valley Behavioral Health Incorporated | Psychiatry | Past | Accepting new patients |
| Community Mental Health for Central Michigan | Psychiatry | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatry Physician
- Mt Pleasant, MI
- NPI 1609412840
-
- Substance Use Disorder Rehabilitation Clinic/Center
- St George, UT
- NPI 1548212640
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- West Valley City, UT
- NPI 1932166980
Psychiatry
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344470400000",
"number": "1013022920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S BALLENGER HWY",
"city": "FLINT",
"state": "MI",
"postal_code": "485323638",
"telephone_number": "810-342-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1254 N MAIN ST",
"city": "LAPEER",
"state": "MI",
"postal_code": "484461343",
"telephone_number": "810-664-4531",
"fax_number": "810-667-7337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALIAN",
"first_name": "GARY",
"middle_name": "MATTHEW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2012-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301053578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11426625",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lapeer, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.