NPIMap

Organization Active NPI

Easter Seals Michigan

  • Registered Nurse
  • Southfield, MI
National Provider Identifier
1043562036
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704068664 Issued in MI
Legal business name
EASTER SEALS MICHIGAN
Practice address
22170 W 9 Mile Rd
Southfield, MI 48033-6007
Phone
(248) 372-6896
NPI assigned
Oct 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Authorized official

Name
Merry Ruth Mitchell, R.N.NPI 1548514540
Title
Registered Psychiatrist Nurse
Phone
(248) 372-6896

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 4704068664 MI Primary

Addresses

Primary practice location

22170 W 9 Mile Rd
Southfield, MI 48033-6007

Mailing address

21395 Oxford Ave
Farmington Hills, MI 48336-6150
Phone (248) 473-1477

National Provider Directory

National Provider Directory

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": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1043562036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21395 OXFORD AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483366150",
            "telephone_number": "248-473-1477",
            "fax_number": "248-893-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22170 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480336007",
            "telephone_number": "248-372-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MERRY",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "REGISTERED PSYCHIATRIST NURSE",
        "authorized_official_telephone_number": "248-372-6896",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704068664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 15, 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.

Verify at the official NPI Registry.