Chaka Chipawe, NP-C
Individual provider Active NPI Adult Health Nurse Practitioner · White Lake, MI
NPI 1104378264 · NPPES record last updated Oct 25, 2016
Key facts
- NPI
- 1104378264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 4704249478 (MI)
- Practice address
- 9178 Highland Rd
White Lake, MI 48386-4619 - Phone
- (248) 698-1999
- NPI assigned
- Oct 25, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Wayne State University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sciometrix LLC
White Lake Family Wellness Inc
Practice addresses (Care Compare)
306 S Washington Ave
Suite 600
Royal Oak, MI 48067-3837
Phone (860) 335-5064
9178 Highland Rd
Suite 1
White Lake, MI 48386-4619
Phone (248) 698-1999
Hospital & facility affiliations
- McLaren Oakland
- Huron Valley-Sinai Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180530003060 | MI | Practitioner - Nurse Practitioner | 7618232349 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Leszkowitz DO PC | Current |
Accepting new patients | |
| Sciometrix Inc | Current |
Accepting new patients | |
| Sciometrix LLC | Current |
Accepting new patients | |
| The Wellness Plan Medical Centers | Current |
Accepting new patients | |
| White Lake Family Wellness Inc | Current |
Accepting new patients | |
| The Wellness Plan Medical Centers | Current |
Accepting new patients | |
| McLaren Oakland | Past | Accepting new patients | |
| The Wellness Plan Medical Centers | Past | Accepting new patients | |
| SJMH Medical Practice-SMHC | Nurse Practitioner | Past | Accepting new patients |
Locations
2888 W Grand Blvd
Detroit, MI 48202
Phone (313) 875-4200
4909 E Outer Dr
Detroit, MI 48234
Phone (313) 366-2000
21040 Greenfield Rd
Oak Park, MI 48237
Phone (248) 967-1888
44405 Woodward Ave
Ste H13
Pontiac, MI 48341
Phone (248) 858-3126
46156 Woodward Ave
Pontiac, MI 48342
Phone (248) 322-6747
306 S Washington Ave
Ste 600
Royal Oak, MI 48067
15565 Northland Dr W
Ste 700
Southfield, MI 48075
9178 Highland Rd
Ste 1
White Lake, MI 48386
Phone (248) 698-1999
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DHDIDD
- https://fhir4.healow.com/fhir/r4/GCBDCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 4704249478 | MI | Yes |
| Gerontology Nurse Practitioner | 363LG0600X | 4704249478 | MI |
Addresses
Primary practice location
9178 Highland Rd
White Lake, MI 48386-4619
Mailing address
1136 Carpenter Dr
Pontiac, MI 48340-3313
Phone (269) 277-0952
Other providers in White Lake, MI
- Brianna Calderon
- David John Campbell
- Sarah Marie Carignan
- Ally Carlson
- Carter Home Care Services
- Carolyn Grace Cianfarani
- Alyssa Jean Claney
- Clarity Counseling and Telehealth Services
- Ashley Clark
- Trisha Clough
All providers in White Lake, MI · Adult Health Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.