Individual provider Active NPI

Chada Natalie Reddy, MD

  • Emergency Medicine Physician
  • Canton, MI
National Provider Identifier
1043298136
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301039083 Issued in MI
Practice address
7300 Canton Center Road
Emergency Medicine Department
Canton, MI 48187-1579
Phone
(734) 454-8002
Fax
(734) 454-2733
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301039083 MI Primary

Addresses

Primary practice location

7300 Canton Center Road
Emergency Medicine Department
Canton, MI 48187-1579

Mailing address

38935 Ann Arbor Road
Credentialing/Payer Contracting Services
Livonia, MI 48150-3397
Phone (734) 632-0175

Other identifiers 2

IdentifierTypeStateIssuer
1043298136MedicaidMI
11286704OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040228000093 MI Practitioner - Emergency Medicine 3274420922 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301039083MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Department Physicians, P.C. Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
Downriver Specialists, P.C. CurrentSince Sep 4, 2018 Accepting new patients
Emergency Professionals of Michigan, P.C. Emergency Medicine CurrentSince May 1, 2014 Accepting new patients

Locations

7300 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

4100 S River Rd
East China, MI 48054
Phone (810) 329-6677

17717 Masonic
Fraser, MI 48026
Phone (586) 294-0600

17700 23 Mile Rd
Macomb, MI 48044
Phone (586) 416-7500

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

18600 Van Horn Rd
Woodhaven, MI 48183
Phone (734) 479-4800

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.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1043298136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR ROAD",
            "address_2": "CREDENTIALING/PAYER CONTRACTING SERVICES",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-632-0175",
            "fax_number": "734-632-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 CANTON CENTER ROAD",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871579",
            "telephone_number": "734-454-8002",
            "fax_number": "734-454-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "CHADA",
        "middle_name": "NATALIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301039083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043298136",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11286704",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.