Individual provider Active NPI

William Waling, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Novi, MI
National Provider Identifier
1104587559
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704311286 Issued in MI
Practice address
44725 Grand River Ave Ste 104
Novi, MI 48375-1024
Phone
(602) 767-2100
NPI assigned
Jan 7, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704311286 MI Primary

Addresses

Primary practice location

44725 Grand River Ave Ste 104
Novi, MI 48375-1024

Mailing address

44725 Grand River Ave Ste 104
Novi, MI 48375-1024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220511002006 MI Practitioner - Nurse Practitioner 0648657783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pure Psychiatry of Michigan PLLCGroup PAC ID 1254741283, 102 clinicians

Practice addresses (Care Compare)

28345 Beck Rd
Suite 110
Wixom, MI 48393-4733
Phone (248) 274-4560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Psychiatry of Michigan PLLC CurrentSince Mar 16, 2024 Accepting new patients
Rowland W Hinds, DO PLLC PastSince Dec 12, 2016 Accepting new patients

Locations

2755 Carpenter Rd
Ste 3SE
Ann Arbor, MI 48108
Phone (734) 548-6099

5715 Bella Rosa Blvd
Ste 200
Clarkston, MI 48348
Phone (248) 657-4639

39600 Garfield Rd
Ste F
Clinton Twp, MI 48038
Phone (586) 307-6566

1429 Flushing Rd
#B
Flushing, MI 48433
Phone (810) 380-5060

3031 Commerce Dr
Ste A
Fort Gratiot, MI 48059
Phone (810) 292-0557

5123 W St Joe Hwy
Ste 205
Lansing, MI 48917
Phone (517) 327-0360

3751 N Dixie Hwy
Monroe, MI 48162
Phone (734) 241-5200

2422 Jolly Rd
Ste 100A
Okemos, MI 48864
Phone (517) 853-1358

9401 General Dr
Ste J
Plymouth, MI 48170
Phone (734) 335-1336

9333 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 414-7231

29600 Northwestern Hwy
Ste 100
Southfield, MI 48034
Phone (248) 353-0050

650 E Big Beaver Rd
Ste C
Troy, MI 48083
Phone (248) 781-8921

34841 Veterans Plz
Wayne, MI 48184
Phone (313) 292-7640

28345 Beck Rd
Ste 110
Wixom, MI 48393
Phone (248) 274-4560

375 Eureka Rd
Ste B
Wyandotte, MI 48192
Phone (734) 225-9300

Interoperability endpoints

  • Direct secure messaging: purepsychiatryofmichigan.williamwaling@153418.advancedmd-direct.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1104587559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44725 GRAND RIVER AVE STE 104",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44725 GRAND RIVER AVE STE 104",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751024",
            "telephone_number": "602-767-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALING",
        "first_name": "WILLIAM",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704311286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.