NPIMap

Organization Active NPI

Center for Digestive Care LLC

  • Ambulatory Surgical Clinic/Center
  • Ypsilanti, MI
National Provider Identifier
1164528527
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
81-6818 Issued in MI
Legal business name
CENTER FOR DIGESTIVE CARE LLC
Practice address
5300 Elliott Dr
Ypsilanti, MI 48197
Phone
(734) 434-6262
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Authorized official

Name
Lana Cooper
Title
Administrator
Phone
(734) 528-1405

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 81-6818 MI Primary
Anesthesiologist AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 367H00000X 4704111201 MI
Anesthesiologist AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 367H00000X 4704204265 MI
Anesthesiologist AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 367H00000X 4704118315 MI

Addresses

Primary practice location

5300 Elliott Dr
Ypsilanti, MI 48197

Mailing address

5300 Elliott Dr
Ypsilanti, MI 48197
Phone (734) 434-6262

Other identifiers 5

IdentifierTypeStateIssuer
40378OtherMIBCBS FACILITY NUMBER
23C0001056OtherMIMEDICARE SUPPLIER #
B0109OtherMIBCN NUMBER
P01162164OtherMIMEDICARE RAILROAD
B0109OtherMIBCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050309000185 MI Part B Supplier - Ambulatory Surgical Center 4981658374 Receives reassigned benefits from 35 practitioners
Practice locations: Ypsilanti, MI

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Center for Digestive Care LLCCCN 23C0001056
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Center for Digestv Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1164528527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-434-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-434-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR DIGESTIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "LANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "734-528-1405"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "81-6818",
            "primary": true
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": "MI",
            "license": "4704111201",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": "MI",
            "license": "4704204265",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": "MI",
            "license": "4704118315",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FACILITY NUMBER",
            "identifier": "40378",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER #",
            "identifier": "23C0001056",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN NUMBER",
            "identifier": "B0109",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01162164",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "B0109",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.