Neurologic & Movement Consultant PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

4301082966 Issued in MI

Legal business name

NEUROLOGIC & MOVEMENT CONSULTANT PC

Practice address

75 Barclay Cir
Suite 230
Rochester Hills, MI 48307-5820

Phone

(586) 495-0982

Fax

(586) 799-4083

NPI assigned

May 4, 2012

Last updated

May 4, 2012By 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

Mary Flaten Shaya, MD

Title

Owner/Med Director

Phone

(586) 495-0982

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1053670497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BARCLAY CIR",
            "address_2": "SUITE 230",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075820",
            "telephone_number": "586-495-0982",
            "fax_number": "586-799-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BARCLAY CIR",
            "address_2": "SUITE 230",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075820",
            "telephone_number": "586-495-0982",
            "fax_number": "586-799-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGIC & MOVEMENT CONSULTANT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-04",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "SHAYA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "FLATEN",
        "authorized_official_title_or_position": "OWNER/MED DIRECTOR",
        "authorized_official_telephone_number": "586-495-0982",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301082966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.