Individual provider Active NPI

Gregory Lee Ware I

  • Peer Specialist
  • Detroit, MI
National Provider Identifier
1114432127
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1600 Porter St
Detroit, MI 48216-1936
Phone
(313) 963-6601
NPI assigned
Dec 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MI Primary

Addresses

Primary practice location

1600 Porter St
Detroit, MI 48216-1936

Mailing address

1600 Porter St
Detroit, MI 48216-1936

Other identifiers 1

IdentifierTypeStateIssuer
W600288497922MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1114432127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PORTER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482161936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PORTER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482161936",
            "telephone_number": "313-963-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARE",
        "first_name": "GREGORY",
        "middle_name": "LEE",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-13",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W600288497922",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.