Natasha Marie Ahmed

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

279 Summit Dr
Waterford, MI 48328-3364

Phone

(248) 745-4900

Fax

(248) 994-8005

NPI assigned

Jun 29, 2023

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

Other names 1

• Natasha Marie Gray, Randle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• CNS Healthcare

  • Psychiatry Physician
  • Novi, MI
  • NPI 1770538068
  NPD (past)
• Northeast Guidance Center

  • Psychiatry Physician
  • Detroit, MI
  • NPI 1922037134
  NPD (past)

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1245917475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430003",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483430003",
            "telephone_number": "248-481-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SUMMIT DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283364",
            "telephone_number": "248-745-4900",
            "fax_number": "248-994-8005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21331 Kelly Rd",
            "address_purpose": "LOCATION",
            "city": "Eastpointe",
            "state": "MI",
            "postal_code": "480213265",
            "country_code": "US",
            "telephone_number": "877-242-4140",
            "fax_number": "248-994-8005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12800 E Warren Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482152061",
            "country_code": "US",
            "telephone_number": "877-242-4140",
            "fax_number": "248-994-8005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20303 Kelly Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482251206",
            "country_code": "US",
            "telephone_number": "877-242-4140",
            "fax_number": "248-994-8005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 Conner St Bldg B",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482152407",
            "country_code": "US",
            "telephone_number": "313-308-1400",
            "fax_number": "313-308-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15560 Joy Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482288200",
            "country_code": "US",
            "telephone_number": "313-668-9300",
            "fax_number": "248-994-8005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24600 Northwestern Hwy",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480752471",
            "country_code": "US",
            "telephone_number": "248-745-4900",
            "fax_number": "248-994-8005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 Conner St Bldg A",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482152407",
            "country_code": "US",
            "telephone_number": "313-308-1400",
            "fax_number": "313-308-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24230 Karim Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483752960",
            "country_code": "US",
            "telephone_number": "248-745-4900",
            "fax_number": "248-994-8005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1841 N Perry St",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483402235",
            "country_code": "US",
            "telephone_number": "248-745-4900",
            "fax_number": "248-994-8005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "NATASHA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATASHA",
            "last_name": "GRAY, RANDLE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Peer Specialist in Waterford, MI
• Providers in Waterford, MI by specialty
• Peer Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.