Active NPI
Andrew Champine, PSYD
- Psychologist
- Flint, MI
National Provider Identifier
1154612299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301016072
- Practice address
- G3230 Beecher Rd Ste 1
Flint, MI 48532-3604 - Phone
- (810) 342-5620
- Fax
- (810) 342-5629
- NPI assigned
- Apr 24, 2011
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301016072 | MI | Primary |
Addresses
Primary practice location
G3230 Beecher Rd Ste 1
Flint, MI 48532-3604
Mailing address
2811 S Mackinaw Rd
Kawkawlin, MI 48631-9117
Phone (989) 450-5496
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301016072 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472515200000",
"number": "1154612299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2811 S MACKINAW RD",
"city": "KAWKAWLIN",
"state": "MI",
"postal_code": "486319117",
"telephone_number": "989-450-5496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "G3230 BEECHER RD STE 1",
"city": "FLINT",
"state": "MI",
"postal_code": "485323604",
"telephone_number": "810-342-5620",
"fax_number": "810-342-5629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPINE",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-24",
"last_updated": "2016-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301016072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.