Active NPI
Individuallytics, Inc.
- Internal Medicine Physician
- Ann Arbor, MI
National Provider Identifier
1164078648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- INDIVIDUALLYTICS, INC.
- Practice address
- 330 E Liberty St
Ann Arbor, MI 48104-2274 - Phone
- (248) 505-3175
- NPI assigned
- Aug 12, 2019
- 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
- Dennis Nash
- Title
- President
- Phone
- (248) 432-0175
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | |||
| Clinical Social Worker | 1041C0700X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Public Health & General Preventive Medicine Physician | 2083P0901X |
Addresses
Primary practice location
330 E Liberty St
Ann Arbor, MI 48104-2274
Mailing address
3765 Sancroft Ave
West Bloomfield, MI 48324-2658
Other practice location 1
46701 Commerce Center Dr
Plymouth, MI 48170-2475
Phone (248) 432-0175
Other names 1
- IndividuALLytics Connected Care
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Humhealth | Health Information Exchange (HIE) | |
| Other URL | iTeleCareHealth | Health Information Exchange (HIE) |
National Provider Directory
National Provider DirectoryLocations
330 E Liberty St
Ann Arbor, MI 48104
Phone (248) 505-3175
46701 Commerce Center Dr
Plymouth, MI 48170
Phone (248) 432-3175
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Psychologist
- West Bloomfield, MI
- NPI 1336773399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565568000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1595980800000",
"number": "1164078648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3765 SANCROFT AVE",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483242658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 E LIBERTY ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481042274",
"telephone_number": "248-505-3175"
}
],
"practiceLocations": [
{
"address_1": "46701 Commerce Center Dr",
"address_purpose": "LOCATION",
"city": "Plymouth",
"state": "MI",
"postal_code": "481702475",
"country_code": "US",
"telephone_number": "248-432-0175",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "INDIVIDUALLYTICS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-12",
"last_updated": "2020-07-29",
"certification_date": "2020-07-29",
"status": "A",
"authorized_official_last_name": "NASH",
"authorized_official_first_name": "DENNIS",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "248-432-0175"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "2083P0901X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Humhealth",
"affiliation": "N",
"endpointDescription": "Chronic Care Management Software",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "46701 Commerce Center Dr",
"city": "Plymouth",
"state": "MI",
"country_code": "US",
"postal_code": "481702475",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "iTeleCareHealth",
"affiliation": "N",
"endpointDescription": "Remote Patient Monitoring Software",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "46701 Commerce Center Dr",
"city": "Plymouth",
"state": "MI",
"country_code": "US",
"postal_code": "481702475",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "IndividuALLytics Connected Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.