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Henry Ford Wyandotte Hospital

Organization Active NPI Nurse Practitioner · Trenton, MI

NPI 1144634403 · NPPES record last updated Jun 10, 2025

Key facts

NPI
1144634403
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 363L00000X
Legal business name
HENRY FORD WYANDOTTE HOSPITAL
Practice address
1640 Fort Street
Suite D Attn Denise
Trenton, MI 48183
Phone
(734) 391-3057
Fax
(734) 391-3052
NPI assigned
Jun 16, 2014
Organization subpart
No

Authorized official

Name
Mark Smith, MD
Title
SVP
Phone
(517) 205-6407

Other NPIs on the same Medicare enrollment 3

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

Corporate family (same tax ID) 20

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 142

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

View all 142

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040227000431 MI Part B Supplier - Clinic/Group Practice 2264334499 Receives reassigned benefits from 245 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rockwood, MI; Wyandotte, MI; Trenton, MI; Southgate, MI; Novi, MI; Brownstown TWP, MI; Allen Park, MI

National Provider Directory

Tax ID family
Henry Ford Wyandotte (21 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X Yes
Certified Registered Nurse Anesthetist
Group: 193200000X MULTI-SPECIALTY GROUP		 367500000X

Addresses

Primary practice location

1640 Fort Street
Suite D Attn Denise
Trenton, MI 48183

Mailing address

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000

Other providers in Trenton, MI

All providers in Trenton, MI · Nurse Practitioner in Michigan

Sources for this page

Verify at the official NPI Registry.