NPIMap

Organization Active NPI

Botsford General Hospital

Doing business as Farmington Village Family Practice (NP)

  • General Practice Registered Nurse
  • Farmington, MI
National Provider Identifier
1134557960
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
Legal business name
BOTSFORD GENERAL HOSPITAL
Doing business as
Farmington Village Family Practice (NP)
Practice address
32754 Grand River Ave
Farmington, MI 48336-3133
Phone
(248) 476-3280
Fax
(248) 476-3286
NPI assigned
Oct 14, 2013
Last updated
Aug 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BOTSFORD GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Authorized official

Name
Lesley Willbrandt
Title
Director Shared Services
Phone
(947) 522-1911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X Primary

Addresses

Primary practice location

32754 Grand River Ave
Farmington, MI 48336-3133

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other names 1

  • Farmington Village Family Practice (NP) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050621000683 MI Part B Supplier - Clinic/Group Practice 2668385238 Receives reassigned benefits from 4 practitioners
3 other NPIs on this enrollment
Practice locations: Redford, MI; Novi, MI; Livonia, MI; Farmington Hills, MI; Farmington, MI; Dearborn Heights, MI

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Botsford Hospital20 organizations share this tax ID, including this one
Part of
Botsford Hospital

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Corewell Health Rehab & Nursing Center-Commons Farmington HillsFarmington Hills, MI, CCN 235462 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 12, 1983
Dec 12, 1983

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Botsford Continuing Care Corporation

    dba Beaumont Rehabilitation & Continuing Care, Farmington Hills

    • Skilled Nursing Facility
    • Farmington Hills, MI
    • NPI 1356374185

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1134557960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32754 GRAND RIVER AVE",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483363133",
            "telephone_number": "248-476-3280",
            "fax_number": "248-476-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTSFORD GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOTSFORD GENERAL HOSPITAL",
        "enumeration_date": "2013-10-14",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "WILLBRANDT",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "DIRECTOR SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-1911"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farmington Village Family Practice (NP)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Farmington Village Family Practice (NP)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, MI

Sources for this page

Verify at the official NPI Registry.