Individual provider Active NPI

Misty Head, CNM, WHNP-BC

  • Advanced Practice Midwife
  • Detroit, MI
National Provider Identifier
1194504035
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704369275 Issued in MI
Practice address
6550 W Warren Ave
Detroit, MI 48210-1134
Phone
(313) 897-7700
NPI assigned
Sep 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704369275 MI
Advanced Practice Midwife 367A00000X 4704369275 MI Primary

Addresses

Primary practice location

6550 W Warren Ave
Detroit, MI 48210-1134

Mailing address

6550 W Warren Ave
Detroit, MI 48210-1134
Phone (313) 897-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108000374 MI Practitioner - Certified Nurse Midwife (CNM) 2062863772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Detroit Community Health Connection IncGroup PAC ID 9234021148, 16 clinicians

Practice addresses (Care Compare)

6550 W Warren Ave
Detroit, MI 48210-1134
Phone (313) 897-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Detroit Community Health Connection, Inc. CurrentSince Dec 18, 2023 Accepting new patients
Detroit Community Health Connection, Inc CurrentSince Dec 18, 2023 Accepting new patients

Locations

6550 W Warren Ave
Detroit, MI 48210
Phone (313) 897-7700

13901 E Jefferson Ave
Detroit, MI 48215
Phone (313) 821-2591

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1194504035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482101134",
            "telephone_number": "313-897-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482101134",
            "telephone_number": "313-897-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "MISTY",
        "credential": "CNM, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704369275",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704369275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.