NPIMap

Individual provider Active NPI

Chaka Chipawe, NP-C

  • Adult Health Nurse Practitioner
  • White Lake, MI
National Provider Identifier
1104378264
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704249478 Issued in MI
Practice address
9178 Highland Rd
White Lake, MI 48386-4619
Phone
(248) 698-1999
NPI assigned
Oct 25, 2016
Last updated
Oct 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704249478 MI Primary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180530003060 MI Practitioner - Nurse Practitioner 7618232349 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
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 LLCGroup PAC ID 7618367087, 58 clinicians
White Lake Family Wellness IncGroup PAC ID 8820518491, 3 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Plan Medical Centers CurrentSince Sep 21, 2020 Accepting new patients
The Wellness Plan Medical Centers CurrentSince Sep 21, 2020 Accepting new patients
Sciometrix Inc CurrentSince Jan 15, 2023 Accepting new patients
David Leszkowitz DO PC CurrentSince Jun 1, 2018 Accepting new patients
Sciometrix LLC CurrentSince Feb 1, 2022 Accepting new patients
White Lake Family Wellness Inc CurrentSince Feb 1, 2025 Accepting new patients
McLaren Oakland Past Accepting new patients
SJMH Medical Practice-SMHC Nurse Practitioner Past Accepting new patients
The Wellness Plan Medical Centers 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) 897-0900

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

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHDIDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/GCBDCD

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1104378264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 CARPENTER DR",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483403313",
            "telephone_number": "269-277-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9178 HIGHLAND RD",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483864619",
            "telephone_number": "248-698-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIPAWE",
        "first_name": "CHAKA",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704249478",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704249478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Lake, MI

Sources for this page

Verify at the official NPI Registry.