NPIMap

Organization Active NPI

Healthspan PLLC

  • Medical Specialty Clinic/Center
  • Grosse Pointe Farms, MI
National Provider Identifier
1245086750
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
HEALTHSPAN PLLC
Practice address
18450 Mack Ave Ste 101
Grosse Pointe Farms, MI 48236-3222
Phone
(313) 583-4333
Fax
(313) 432-8135
NPI assigned
Apr 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Ginette Gomez, DONPI 1104840271
Title
Cardiologist/Owner
Phone
(313) 583-4333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

18450 Mack Ave Ste 101
Grosse Pointe Farms, MI 48236-3222

Mailing address

18450 Mack Ave Ste 101
Grosse Pointe Farms, MI 48236-3222
Phone (313) 583-4333

National Provider Directory

National Provider Directory

Locations

18450 Mack Ave
Ste 101
Grosse Pointe Farms, MI 48236
Phone (313) 583-4333

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1245086750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18450 MACK AVE STE 101",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363222",
            "telephone_number": "313-583-4333",
            "fax_number": "313-432-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18450 MACK AVE STE 101",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363222",
            "telephone_number": "313-583-4333",
            "fax_number": "313-432-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSPAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "GINETTE",
        "authorized_official_title_or_position": "CARDIOLOGIST/OWNER",
        "authorized_official_telephone_number": "313-583-4333",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.