Active NPI
Repose PLLC
- Otolaryngology/Facial Plastic Surgery Physician
- Clinton Township, MI
National Provider Identifier
1144944349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology/Facial Plastic Surgery Physician
- Legal business name
- REPOSE PLLC
- Practice address
- 36539 Harper Ave
Clinton Township, MI 48035-2012 - Phone
- (586) 228-0600
- Fax
- (920) 356-6419
- NPI assigned
- Sep 30, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelsey A Pattee
- Title
- Practice Manager
- Phone
- (920) 356-6416
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | Primary |
Addresses
Primary practice location
36539 Harper Ave
Clinton Township, MI 48035-2012
Mailing address
120 Park Ave Ste 1
Beaver Dam, WI 53916-2132
Phone (920) 885-5225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
36557 Harper Ave
Clinton Twp, MI 48035
Phone (586) 228-0600
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Otolaryngology/Facial Plastic Surgery Physician
- Clinton Township, MI
- NPI 1639375884
-
- Audiologist
- Clinton Township, MI
- NPI 1114571460
-
- Otolaryngology/Facial Plastic Surgery Physician
- Beaver Dam, WI
- NPI 1346450558
MI
-
- Family Nurse Practitioner
- Roseville, MI
- NPI 1538870597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664496000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1704931200000",
"number": "1144944349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 PARK AVE STE 1",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539162132",
"telephone_number": "920-885-5225",
"fax_number": "920-356-6419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36539 HARPER AVE",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480352012",
"telephone_number": "586-228-0600",
"fax_number": "920-356-6419"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REPOSE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-30",
"last_updated": "2024-01-11",
"certification_date": "2024-01-11",
"status": "A",
"authorized_official_last_name": "PATTEE",
"authorized_official_first_name": "KELSEY",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "920-356-6416"
},
"taxonomies": [
{
"code": "207YX0905X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": null,
"license": null,
"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 Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.