Organization Active NPI

Online Controlled Kravings Weight Loss PLLC

  • General Practice Physician
  • Southfield, MI
National Provider Identifier
1043096761
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC
Practice address
21701 W 11 Mile Rd Ste 5
Southfield, MI 48076-3713
Phone
(248) 429-9556
NPI assigned
Sep 7, 2023
Organization subpart
Yes
Parent organization
ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Zakari Tata, MD
Title
Authorized Official
Phone
(248) 429-9556

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

21701 W 11 Mile Rd Ste 5
Southfield, MI 48076-3713

Mailing address

21701 W 11 Mile Rd Ste 5
Southfield, MI 48076-3713
Phone (248) 429-9556

Other names 1

  • Chronic Disease and Health Management Doing business as

National Provider Directory

National Provider Directory
Part of
Online Controlled Kravings Weight Loss PLLC

Locations

21701 W 11 Mile Rd
Ste 5
Southfield, MI 48076
Phone (248) 747-1690

Practitioners & affiliated clinicians

Practitioners 1

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": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1043096761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21701 W 11 MILE RD STE 5",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763713",
            "telephone_number": "248-429-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21701 W 11 MILE RD STE 5",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763713",
            "telephone_number": "248-429-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "TATA",
        "authorized_official_first_name": "ZAKARI",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "248-429-9556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chronic Disease and Health Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.