Active NPI
Halo Pediatrics
- Pediatrics Physician
- Detroit, MI
National Provider Identifier
1215494125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- HALO PEDIATRICS
- Practice address
- 17600 W Warren Ave
Detroit, MI 48228-3509 - Phone
- (313) 450-4411
- NPI assigned
- Feb 27, 2019
- Last updated
- Feb 27, 2019
- Organization subpart
- Yes
- Parent organization
- HALO MEDICAL GROUP PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hanady Beydoun
- Title
- Office Manager
- Phone
- (313) 993-7777
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
17600 W Warren Ave
Detroit, MI 48228-3509
Mailing address
22720 Michigan Ave Ste 200
Dearborn, MI 48124-2021
Phone (313) 450-4411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13511211 | Other | CAQH |
National Provider Directory
National Provider Directory- Tax ID family
- Halo Primary Care
- Part of
- Halo Primary Care
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Endocrinology, Diabetes & Metabolism Physician
- Detroit, MI
- NPI 1386101285
-
- Family Nurse Practitioner
- Detroit, MI
- NPI 1750604526
-
- Family Medicine Physician
- Detroit, MI
- NPI 1386101293
-
- Physical Therapist
- Southfield, MI
- NPI 1902467145
-
- Cardiovascular Disease Physician
- Dearborn, MI
- NPI 1679030530
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Cardiovascular Disease Physician
- Detroit, MI
- NPI 1962427260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551225600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1551225600000",
"number": "1215494125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22720 MICHIGAN AVE STE 200",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242021",
"telephone_number": "313-450-4411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17600 W WARREN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482283509",
"telephone_number": "313-450-4411"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HALO PEDIATRICS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HALO MEDICAL GROUP PLLC",
"enumeration_date": "2019-02-27",
"last_updated": "2019-02-27",
"status": "A",
"authorized_official_last_name": "BEYDOUN",
"authorized_official_first_name": "HANADY",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "313-993-7777"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13511211",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.