NPIMap

Botsford General Hospital

Organization Active NPI General Practice Registered Nurse · Farmington, MI

NPI 1134557960 · NPPES record last updated Aug 16, 2019

Key facts

NPI
1134557960
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Registered Nurse 163WG0000X
Legal business name
BOTSFORD GENERAL HOSPITAL
Practice address
32754 Grand River Ave
Farmington, MI 48336-3133
Phone
(248) 476-3280
Fax
(248) 476-3286
NPI assigned
Oct 14, 2013
Organization subpart
Yes
Parent organization (as reported)
BOTSFORD GENERAL HOSPITAL

Authorized official

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

Owned or controlled facilities with NPI records 1

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

Other NPIs on the same Medicare enrollment 3

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

Other NPIs with the same Medicare PAC ID 7

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

Corporate family (same tax ID) 19

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

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 50

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

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 Hills
Farmington Hills, MI · CCN 235462		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 12, 1983
Dec 12, 1983

Medicare enrollment records

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

National Provider Directory

Tax ID family
ER Phys-Botsford Gen Ho (20 organizations share this tax ID)
Part of
ER Phys-Botsford Gen Ho

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse
Group: 193400000X SINGLE SPECIALTY GROUP		 163WG0000X Yes

Addresses

Primary practice location

32754 Grand River Ave
Farmington, MI 48336-3133

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other names

  • Farmington Village Family Practice (NP) Doing business as

Other providers in Farmington, MI

All providers in Farmington, MI · General Practice Registered Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.