NPIMap

Organization Active NPI

Botsford General Hospital

  • Neuromusculoskeletal Medicine & OMM Physician
  • Novi, MI
National Provider Identifier
1013079573
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
Legal business name
BOTSFORD GENERAL HOSPITAL
Practice address
39750 Grand River Ave
Attn Omm Clinic
Novi, MI 48375-2106
Phone
(248) 477-6100
Fax
(248) 473-8480
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Nancy Susick
Title
Chief Operating Officer
Phone
(947) 522-3338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 204D00000X Primary

Addresses

Primary practice location

39750 Grand River Ave
Attn Omm Clinic
Novi, MI 48375-2106

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849
Phone (947) 522-1963

Other names 1

  • Botsford Hospital OMM TRACC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
ER Phys-Botsford Gen Ho20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

39750 Grand River Ave
Novi, MI 48375
Phone (248) 473-3100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1013079573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39750 GRAND RIVER AVE",
            "address_2": "ATTN OMM CLINIC",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752106",
            "telephone_number": "248-477-6100",
            "fax_number": "248-473-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTSFORD GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "SUSICK",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "947-522-3338"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Botsford Hospital OMM TRACC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Botsford Hospital OMM TRACC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.