NPIMap

Organization Active NPI

William Beaumont Hospital

  • Emergency Medicine Physician
  • West Bloomfield, MI
National Provider Identifier
1184174963
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
WILLIAM BEAUMONT HOSPITAL
Practice address
6900 Orchard Lake Rd Ste 100
Beaumont Urgent Care
West Bloomfield, MI 48322-3424
Phone
(248) 855-4134
NPI assigned
Oct 5, 2016
Last updated
Oct 1, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BEAUMONT URGENT CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Lee Ann Odom
Title
President Shared Services
Phone
(947) 522-3326

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MI
Nurse Practitioner 363L00000X MI
Emergency Medicine Physician 207P00000X MI Primary

Addresses

Primary practice location

6900 Orchard Lake Rd Ste 100
Beaumont Urgent Care
West Bloomfield, MI 48322-3424

Mailing address

26901 Beaumont Blvd
Compliance
Southfield, MI 48033-4716
Phone (947) 522-1964

Other identifiers 3

IdentifierTypeStateIssuer
0F362410OtherMIBCBSM
0F359270OtherMIBCBSM
0F399250OtherMIBCBSM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.beaumont.edu

National Provider Directory

National Provider Directory
Tax ID family
William Beaumont Hospital118 organizations share this tax ID, including this one
Part of
William Beaumont Hospital

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1184174963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "address_2": "COMPLIANCE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334716",
            "telephone_number": "947-522-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ORCHARD LAKE RD STE 100",
            "address_2": "BEAUMONT URGENT CARE",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223424",
            "telephone_number": "248-855-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BEAUMONT HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUMONT URGENT CARE",
        "enumeration_date": "2016-10-05",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-3326"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F362410",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F359270",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F399250",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "6900 Orchard Lake Rd Ste 100",
            "address_2": "Beaumont Urgent Care",
            "city": "West Bloomfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483223424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.