NPIMap

Organization Active NPI

Botsford General Hospital

  • Dermatology Physician
  • Farmington Hills, MI
National Provider Identifier
1184665986
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BOTSFORD GENERAL HOSPITAL
Practice address
21141 Middlebelt Rd
Farmington Hills, MI 48336-5516
Phone
(248) 476-4295
Fax
(248) 476-9403
NPI assigned
Jun 10, 2006
Last updated
Aug 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BOTSFORD GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Authorized official

Name
Lesley Willbrandt
Title
Director Shared Services
Phone
(947) 522-1911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

21141 Middlebelt Rd
Farmington Hills, MI 48336-5516

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other names 1

  • Botsford Dermatology Clinic Other name

National Provider Directory

National Provider Directory
Part of
ER Phys-Botsford Gen Ho

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1184665986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21141 MIDDLEBELT RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365516",
            "telephone_number": "248-476-4295",
            "fax_number": "248-476-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTSFORD GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOTSFORD GENERAL HOSPITAL",
        "enumeration_date": "2006-06-10",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "WILLBRANDT",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "DIRECTOR SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-1911"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Botsford Dermatology Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Botsford Dermatology Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.