NPIMap

Organization Active NPI

Main Street Pediatrics PLLC

  • Pediatrics Physician
  • West Bloomfield, MI
National Provider Identifier
1073853008
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301088451 Issued in MI
Legal business name
MAIN STREET PEDIATRICS PLLC
Practice address
7362 Rafford LN
West Bloomfield, MI 48322-3190
Phone
(248) 819-2664
NPI assigned
Feb 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Rhonda Yono-Atisha, MD
Title
Managing Member
Phone
(248) 819-2664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 4301088451 MI Primary

Addresses

Primary practice location

7362 Rafford LN
West Bloomfield, MI 48322-3190

Mailing address

7362 Rafford LN
West Bloomfield, MI 48322-3190

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1073853008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7362 RAFFORD LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7362 RAFFORD LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223190",
            "telephone_number": "248-819-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "YONO-ATISHA",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "248-819-2664",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301088451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.