Individual provider Active NPI

Gina Rose Hilgendorf

  • Psychologist
  • Clinton Township, MI
National Provider Identifier
1144598616
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301012131 Issued in MI
Practice address
22550 Hall Rd
Clinton Township, MI 48036-1189
Phone
(586) 948-6162
Fax
(586) 469-7674
NPI assigned
Dec 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301012131 MI Primary

Addresses

Primary practice location

22550 Hall Rd
Clinton Township, MI 48036-1189

Mailing address

22550 Hall Rd
Clinton Township, MI 48036-1189
Phone (586) 948-6162

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

State licenses

LicenseStateTypeSpecialty
6301012131MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1144598616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22550 HALL RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480361189",
            "telephone_number": "586-948-6162",
            "fax_number": "586-469-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22550 HALL RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480361189",
            "telephone_number": "586-948-6162",
            "fax_number": "586-469-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILGENDORF",
        "first_name": "GINA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.