NPIMap

Individual provider Active NPI

Jean Gash, NURSE PRACTITIONER

  • Nurse Practitioner
  • Bloomfield Township, MI
National Provider Identifier
1205976537
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704099640 Issued in MI
Practice address
4669 Ravine Dr
Bloomfield Township, MI 48301
Phone
(248) 594-7442
NPI assigned
Feb 7, 2007
Last updated
May 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704099640 MI Primary

Addresses

Primary practice location

4669 Ravine Dr
Bloomfield Township, MI 48301

Mailing address

4669 Ravine Dr
Bloomfield Township, MI 48301-3640
Phone (248) 594-7442

Other identifiers 1

IdentifierTypeStateIssuer
JG099640OtherMIBCBSM

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Institute of Urology PC Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Michigan Institute of Urology, PC Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Michigan Institute of Urology Laboratory Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Nurse Practitioner Past Accepting new patients
Michigan Institute of Urology, PC Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Michigan Institute of Urology, PC Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Michigan Institute of Urology PC Nurse Practitioner Past Accepting new patients
Alliance Physician Services of Michigan, P.C. Past Accepting new patients
Michigan Institute of Urology, PC Past Accepting new patients
Michigan Institute of Urology, PC Past Accepting new patients
Michigan Institute of Urology PC Nurse Practitioner Past Accepting new patients
Michigan Institute of Urology, PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc05115_tricountyurologists

Organizations & group practices 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1205976537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4669 RAVINE DR",
            "city": "BLOOMFIELD TOWNSHIP",
            "state": "MI",
            "postal_code": "483013640",
            "telephone_number": "248-594-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4669 RAVINE DR",
            "city": "BLOOMFIELD TOWNSHIP",
            "state": "MI",
            "postal_code": "48301",
            "telephone_number": "248-594-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASH",
        "first_name": "JEAN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704099640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "JG099640",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.