Billy R Nordyke Jr DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101018163 Issued in MI

Legal business name

BILLY R NORDYKE JR DO PC

Practice address

2201 Ford Ave
Wyandotte, MI 48192-2314

Phone

(734) 258-8835

Fax

(734) 258-8885

NPI assigned

Aug 21, 2018

Organization subpart

No

Name

Dr. Billy Ralph Nordyke, DONPI 1700817558

Title

DO/Ceo

Phone

(734) 758-8835

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Billy Ralph Nordyke Jr., D.O.

  • Family Medicine Physician
  • Wyandotte, MI
  • NPI 1700817558

  MI

  Medicare reassignment Authorized official
• Brittany J Regalado, FNP-C

  • Family Medicine Physician
  • Wyandotte, MI
  • NPI 1104557537

  Family Medicine, MI

  Medicare reassignment NPD
• Krista Ross, NP-C

  • Nurse Practitioner
  • Royal Oak, MI
  • NPI 1831973874

  MI

  Medicare reassignment NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in MI

• Nordyke Family Medicine Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 31, 2019.

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1235619065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922314",
            "telephone_number": "734-258-8835",
            "fax_number": "734-258-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922314",
            "telephone_number": "734-258-8835",
            "fax_number": "734-258-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILLY R NORDYKE JR DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "NORDYKE",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "DO/CEO",
        "authorized_official_telephone_number": "734-758-8835",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101018163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nordyke Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nikhil D Bhagat, R.PH
• Sameer Surendra Bhagwan, M.D.
• Biddle Drugs, Inc.
• Biddle Pharmacy LLC
• Roger A Bigelow, MSW, CSW
• Kellie Jasmine Blank, PA-C
• Margaret L Blevins, LLP
• Bliss Oral & Facial Surgery
• Amy Lynn Bliss, D.O.
• Robin Alan Blumer, MD

• All providers in Wyandotte, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.