Active NPI
Advanced Asthma Allergy & Immunology Care PC
- Allergy Physician
- Ypsilanti, MI
National Provider Identifier
1053577536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- CC788218
- Legal business name
- ADVANCED ASTHMA ALLERGY & IMMUNOLOGY CARE PC
- Practice address
- 4870 W Clark Rd
Suite 202
Ypsilanti, MI 48197-1104 - Phone
- (734) 434-5430
- Fax
- (734) 434-5762
- NPI assigned
- Aug 4, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Lisa Stringham
- Title
- Credentialing Manager
- Phone
- (269) 969-8920
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | CC788218 | MI | Primary |
Addresses
Primary practice location
4870 W Clark Rd
Suite 202
Ypsilanti, MI 48197-1104
Mailing address
49 S Cass St
Battle Creek, MI 49037-2331
Phone (269) 969-8920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104929015 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
49 Cass St S
Battle Creek, MI 49037
2140 Washtenaw Rd
Ypsilanti, MI 48197
Phone (734) 434-5430
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Allergy Physician
- Detroit, MI
- NPI 1275550287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217808000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1217808000000",
"number": "1053577536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 S CASS ST",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490372331",
"telephone_number": "269-969-8920",
"fax_number": "269-969-8921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4870 W CLARK RD",
"address_2": "SUITE 202",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971104",
"telephone_number": "734-434-5430",
"fax_number": "734-434-5762"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED ASTHMA ALLERGY & IMMUNOLOGY CARE PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-04",
"last_updated": "2008-08-04",
"status": "A",
"authorized_official_last_name": "STRINGHAM",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "269-969-8920",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Allergy & Immunology, Allergy",
"state": "MI",
"license": "CC788218",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104929015",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.