Active NPI
Ray Todd Everhart, MDIV
- Religious Nonmedical Practitioner
- Detroit, MI
National Provider Identifier
1144090754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Religious Nonmedical Practitioner
- Practice address
- 4646 John R St
Detroit, MI 48201-1916 - Phone
- (313) 576-1000
- NPI assigned
- Jan 4, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Religious Nonmedical Practitioner | 374K00000X | Primary |
Addresses
Primary practice location
4646 John R St
Detroit, MI 48201-1916
Mailing address
702 Bauman Ave
Royal Oak, MI 48073-2068
Phone (303) 746-3334
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": "1704326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1144090754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 BAUMAN AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480732068",
"telephone_number": "303-746-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERHART",
"first_name": "RAY",
"middle_name": "TODD",
"credential": "MDIV",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-04",
"last_updated": "2024-01-04",
"certification_date": "2024-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "374K00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.