Henry Ford Health System
Organization Active NPI Nurse Practitioner · Detroit, MI
NPI 1104900455 · NPPES record last updated Mar 6, 2024
Key facts
- NPI
- 1104900455
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 830190 (MI)
- Legal business name
- HENRY FORD HEALTH SYSTEM
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-2600
- NPI assigned
- Oct 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Kelly Ratowski
- Title
- Director-Provider Affairs
- Phone
- (248) 703-2003
Corporate family (same tax ID) 24
Practitioners 583
-
Fatmeh Abdallah, FNP
-
Lauren Bobbi Nicole Adams-Sanantonio, DNP, AGPCNP-BC
-
Rachel Adler, FNP-C
-
Colleen Devoe Altman, CRNP
-
Amy D Andrews, ACAGNP
-
Kari Anglin, NP
-
Robinetta Elizabeth Armstrong, ACNP-BC
-
Andres Ayala, NP.
-
Ali K Ayoub, FNP
-
Jenna Babcock, NP-C
-
Heather Bachert, ANP-BC
-
Jessica Lynn Baginski, MSN, RN, AGACNP-BC
-
Kimberly Gutowsky Baker, FNP-C
-
Kristin Marie Bakos, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
All facility ownership & control disclosures 26
| Facility | Type | Role | Since |
|---|---|---|---|
| Henry Ford Genesys Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Providence Southfield Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Providence Southfield Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Providence Southfield Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Genesys Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health - St. John Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Warren Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Madison Heights Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Heights Madison Heights Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Macomb Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1966 |
| Henry Ford Macomb Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2007 |
| Henry Ford Health - St. John Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2025 |
| Wyandotte Hospital and Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Wyandotte Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Wyandotte Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Rochester Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Rochester Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Rochester Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Jackson Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Apr 1, 2016 |
| Henry Ford Health Jackson Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Apr 1, 2016 |
| Henry Ford Health Brighton Center for Recovery |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health River District Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health - St. John Hospital |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | Dec 18, 1987 |
| Henry Ford Health Behavioral Health Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (17.4%) General Partnership Interest (17.4%) |
Feb 23, 2025 Feb 23, 2025 |
| Henry Ford Health Jackson Hospital |
Home health agency | 5% Or Greater Indirect Ownership Interest (100%) | Apr 1, 2016 |
| Henry Ford Allegiance Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031210000341 | MI | Part B Supplier - Clinic/Group Practice | 0547178311 |
Receives reassigned benefits from 565 practitioners Practice locations: Taylor, MI; Sterling Heights, MI; Southfield, MI; Saint Clair Shores, MI; Royal Oak, MI; Plymouth, MI; Novi, MI; Northville, MI… |
National Provider Directory
- Tax ID family
- Henry for Hospital
Locations
1 Ford Pl
Ste 1F
Detroit, MI 48202
Phone (313) 874-4907
45 Grand River Ave
Detroit, MI 48226
Phone (313) 324-8177
3500 15 Mile Rd
Sterling Hts, MI 48310
Phone (586) 977-9300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | 830190 | MI | Yes |
| Adult Health Nurse Practitioner |
363LA2200X | |||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
NPI Registry JSON
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1709683200000",
"number": "1104900455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-2600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HENRY FORD HEALTH SYSTEM",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-24",
"last_updated": "2024-03-06",
"certification_date": "2024-03-06",
"status": "A",
"authorized_official_last_name": "RATOWSKI",
"authorized_official_first_name": "KELLY",
"authorized_official_title_or_position": "DIRECTOR-PROVIDER AFFAIRS",
"authorized_official_telephone_number": "248-703-2003",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "830190",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
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All providers in Detroit, MI · 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 Mar 6, 2024. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.