NPIMap

Individual provider Active NPI

Jyothi R. Nichanametla, M.D.

  • Obstetrics & Gynecology Physician
  • Canton, MI
National Provider Identifier
1144332800
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301079947 Issued in MI
Practice address
5820 N Canton Center Rd Ste 120
Canton, MI 48187-2679
Phone
(734) 981-2800
Fax
(734) 981-9028
NPI assigned
Aug 31, 2006
Last updated
May 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301079947 MI Primary

Addresses

Primary practice location

5820 N Canton Center Rd Ste 120
Canton, MI 48187-2679

Mailing address

5820 N Canton Center Rd Ste 120
Canton, MI 48187-2679
Phone (734) 981-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061017000070 MI Practitioner - Obstetrics/Gynecology 8820094774 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5820 N Canton Ctr Rd
Suite 120
Canton, MI 48187-2679
Phone (734) 981-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Mercy Hospital Crna Current Accepting new patients
Divine Arrival LLC Current Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Jan 23, 2010 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Dec 21, 2019 Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Jan 23, 2010 Accepting new patients
State of Michigan Office of Financial Management CurrentSince Jan 7, 2017 Accepting new patients
State of Michigan Office of Financial Management CurrentSince Jan 7, 2017 Accepting new patients
St Mary Mercy Hospital Professional Current Accepting new patients
Womens Life Cycles OB GYN PC Obstetrics & Gynecology CurrentSince Nov 1, 2009 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

42287 Cherry Hill Rd
Ste D
Canton, MI 48188
Phone (734) 667-5218

5820 N Canton Center Rd
Ste 120
Canton, MI 48187
Phone (734) 459-3838

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

30901 Palmer Rd
Westland, MI 48186
Phone (734) 367-8400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAEBBA/Endpoint/CAEBBA
  • Direct secure messaging: jnichanametla1248855@epic00.shdirect.org
  • Direct secure messaging: jnichanametla37083@direct.trinity-health.org
  • Direct secure messaging: jnichanametla58887@direct.hfhs.org

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1144332800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 N CANTON CENTER RD STE 120",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872679",
            "telephone_number": "734-981-2800",
            "fax_number": "734-981-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 N CANTON CENTER RD STE 120",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872679",
            "telephone_number": "734-981-2800",
            "fax_number": "734-981-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHANAMETLA",
        "first_name": "JYOTHI",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301079947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.