New Castle Haggerty Medical Partners PA

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

NEW CASTLE HAGGERTY MEDICAL PARTNERS PA

Practice address

21333 Haggerty Rd
Suite 150
Novi, MI 48375-5510

Phone

(248) 662-0250

Fax

(248) 662-9845

NPI assigned

Mar 18, 2016

Organization subpart

No

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

Authorized official

Name

Thomas M Prose, MD

Title

President

Phone

(248) 662-0250

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470268800000",
    "number": "1154782183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21333 HAGGERTY RD",
            "address_2": "SUITE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755510",
            "telephone_number": "248-662-0250",
            "fax_number": "248-662-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21333 HAGGERTY RD",
            "address_2": "SUITE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483755510",
            "telephone_number": "248-662-0250",
            "fax_number": "248-662-9845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CASTLE HAGGERTY MEDICAL PARTNERS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-08-04",
        "status": "A",
        "authorized_official_last_name": "PROSE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-662-0250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Novi, MI
• Providers in Novi, MI by specialty
• Geriatric Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.

Verify at the official NPI Registry.