Organization Active NPI

Salta of Troy, PLLC

  • Family Medicine Physician
  • Troy, MI
National Provider Identifier
1104462886
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SALTA OF TROY, PLLC
Practice address
1631 W Big Beaver Rd
Troy, MI 48084-3501
Phone
(248) 781-9655
Fax
(248) 781-9665
NPI assigned
Nov 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Authorized official

Name
John A Blanchard, MD
Title
Ceo
Phone
(248) 206-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1631 W Big Beaver Rd
Troy, MI 48084-3501

Mailing address

1627 W Big Beaver Rd
Troy, MI 48084-3501
Phone (248) 220-1560

National Provider Directory

National Provider Directory

Locations

1631 W Big Beaver Rd
Troy, MI 48084
Phone (248) 781-9655

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1104462886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 W BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843501",
            "telephone_number": "248-220-1560",
            "fax_number": "248-220-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 W BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843501",
            "telephone_number": "248-781-9655",
            "fax_number": "248-781-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALTA OF TROY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-206-1200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.