Active NPI
Patricia A. Gottschalk, N.P.
- Gerontology Nurse Practitioner
- Novi, MI
National Provider Identifier
1174783591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 4704134424
- Practice address
- 21333 Haggerty Rd
Suite 150
Novi, MI 48375-5510 - Phone
- (248) 662-0250
- Fax
- (248) 662-9844
- NPI assigned
- Jun 10, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 4704134424 | MI | Primary |
Addresses
Primary practice location
21333 Haggerty Rd
Suite 150
Novi, MI 48375-5510
Mailing address
21333 Haggerty Rd
Suite 150
Novi, MI 48375-5510
Phone (248) 662-0250
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704134424 | MI | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1174783591",
"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": "248-662-9844"
},
{
"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": "248-662-9844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTSCHALK",
"first_name": "PATRICIA",
"middle_name": "A.",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-10",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MI",
"license": "4704134424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.