Organization Active NPI

University Neurosurgical Associates, PC

Doing business as Michigan Head and Spine Institute

  • Neurological Surgery Physician
  • Clinton TWP, MI
National Provider Identifier
1053698191
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
UNIVERSITY NEUROSURGICAL ASSOCIATES, PC
Doing business as
Michigan Head and Spine Institute
Practice address
43475 Dalcoma Dr Ste 150
Clinton TWP, MI 48038-3594
Phone
(248) 784-3667
Fax
(248) 784-3678
NPI assigned
Nov 3, 2011
Last updated
Apr 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Authorized official

Name
Robert Johnson, MDNPI 1861489452
Title
President
Phone
(248) 784-3667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

43475 Dalcoma Dr Ste 150
Clinton TWP, MI 48038-3594

Mailing address

29275 Northwestern Hwy
Ste 100
Southfield, MI 48034-1044
Phone (248) 784-3667

Other names 1

  • Michigan Head and Spine Institute Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2020358Michigan Head & Spine Institute43475 Dalcoma Drive Suite 150, Clinton Township, MI 48038Certificate of waiverMay 2, 2028

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1053698191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY",
            "address_2": "STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341044",
            "telephone_number": "248-784-3667",
            "fax_number": "248-784-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR STE 150",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383594",
            "telephone_number": "248-784-3667",
            "fax_number": "248-784-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY NEUROSURGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-03",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-784-3667",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Head and Spine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.