NPIMap

Organization Active NPI

Oakwood Southshore Surgery Center, LLC

Doing business as Oakwood Southshore Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Trenton, MI
National Provider Identifier
1083653935
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
826847 Issued in MI
Legal business name
OAKWOOD SOUTHSHORE SURGERY CENTER, LLC
Doing business as
Oakwood Southshore Surgery Center
Practice address
5452 Fort St
Suite 100
Trenton, MI 48183-4601
Phone
(734) 479-7070
Fax
(734) 479-7074
NPI assigned
Jun 6, 2006
Last updated
Oct 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Authorized official

Name
Mr. Barry M Cullen
Title
Board Manager
Phone
(313) 982-3010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 826847 MI Primary

Addresses

Primary practice location

5452 Fort St
Suite 100
Trenton, MI 48183-4601

Mailing address

5452 Fort St
Suite 100
Trenton, MI 48183-4601
Phone (734) 479-7070

Other names 1

  • Oakwood Southshore Surgery Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1083653935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5452 FORT ST",
            "address_2": "SUITE 100",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834601",
            "telephone_number": "734-479-7070",
            "fax_number": "734-479-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5452 FORT ST",
            "address_2": "SUITE 100",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834601",
            "telephone_number": "734-479-7070",
            "fax_number": "734-479-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKWOOD SOUTHSHORE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BOARD MANAGER",
        "authorized_official_telephone_number": "313-982-3010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "826847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakwood Southshore Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.