Organization Active NPI

Individuallytics, Inc.

  • Internal Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1164078648
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Jul 29, 2020

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)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Humhealth Health Information Exchange (HIE)
Other URL iTeleCareHealth Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.