Pati Putt Church, CUNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704211868 Issued in MI

Practice address

1500 East Medical Center Drive
B1 Floor Cancer & Geriatric Center Recp C
Ann Arbor, MI 48109-5913

Phone

(734) 647-8903

Fax

(734) 647-8860

NPI assigned

Dec 28, 2006

Last updated

Mar 26, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pati.church.1@18740.direct.athenahealth.com
• Direct secure messaging: pchurch1121190@direct.hfhs.org

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.

• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  dba Urology Specialist of Michigan

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1225194038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SOUTH STATE STREET",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DRIVE",
            "address_2": "B1 FLOOR CANCER & GERIATRIC CENTER RECP C",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095913",
            "telephone_number": "734-647-8903",
            "fax_number": "734-647-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "PATI",
        "middle_name": "PUTT",
        "name_prefix": "Mrs.",
        "credential": "CUNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704211868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Maven Chung, MD
• Kevin CHI Chung, MD
• Ray-Yuan Chung, RD
• Daniel Church
• Joseph Thomas Church, M.D.
• Kaissa Lynn-Moon Cianfarani
• Juan Sebastian Cifuentes Munoz, MD
• Abigail Marie Cimini, PT, DPT
• Vincent M Cimmino, MD
• Joshua Cimpian

• Nurse Practitioner in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.