Active NPI
Jennifer L Rise
- Internal Medicine Physician
- Warren, MI
National Provider Identifier
1114947959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 5101011870
- Practice address
- 13355 E 10 Mile Rd
Suite 229
Warren, MI 48089-2048 - Phone
- (586) 758-6263
- Fax
- (586) 758-7725
- NPI assigned
- Jul 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5101011870 | MI | Primary |
Addresses
Primary practice location
13355 E 10 Mile Rd
Suite 229
Warren, MI 48089-2048
Mailing address
37399 Garfield Rd
Ste 203
Clinton TWP, MI 48036-3672
Phone (586) 228-2911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3263097 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571097600000",
"number": "1114947959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37399 GARFIELD RD",
"address_2": "STE 203",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480363672",
"telephone_number": "586-228-2911",
"fax_number": "586-228-2901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13355 E 10 MILE RD",
"address_2": "SUITE 229",
"city": "WARREN",
"state": "MI",
"postal_code": "480892048",
"telephone_number": "586-758-6263",
"fax_number": "586-758-7725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISE",
"first_name": "JENNIFER",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2019-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5101011870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3263097",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.