Baddigam Family Psychiatric Assoc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

BADDIGAM FAMILY PSYCHIATRIC ASSOC

Practice address

15500 19 Mile Rd
Ste 310
Clinton TWP, MI 48038-6330

Phone

(586) 263-6812

NPI assigned

Dec 20, 2007

Last updated

Dec 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Prameela Baddigam, MDNPI 1952302861

Title

Owner

Phone

(586) 263-6812

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• Psychology Group Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Baddigam Family Psychiatric Associates PLLC

  • Psychiatry Physician
  • Clinton Township, MI
  • NPI 1093899569

  O20050920000652

  Same enrollment

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prameela Devi Baddigam, MD MBA

  • Psychiatry Physician
  • Redlands, CA
  • NPI 1952302861
  NPD Authorized official
• Basivi Reddy Baddigam, MD

  • Child & Adolescent Psychiatry Physician
  • Clinton TWP, MI
  • NPI 1386645299
  NPD

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1033393442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15500 19 MILE RD",
            "address_2": "STE 310",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386330",
            "telephone_number": "586-263-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15500 19 MILE RD",
            "address_2": "STE 310",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386330",
            "telephone_number": "586-263-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BADDIGAM FAMILY PSYCHIATRIC ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "BADDIGAM",
        "authorized_official_first_name": "PRAMEELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-263-6812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "MC012228",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4769047",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4769056",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "JT007751",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0E02096",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychology Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Laqua Armstrong, COTA/L
• Linda P Audia, CRNA
• Audionet America Inc
• Raad Ausi, M.D.
• Azaria Legacy Home Care, LLC
• Basivi Reddy Baddigam, MD
• Baek & Weeden Medical & Sports Supplies
• Charlene Bailey, P.A. C.
• Phylicia Bailey
• Baker & Ochs, P.C.

• Clinical Psychologist in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.