Individual provider Active NPI

Walli Bellairs, MSW

  • Social Worker
  • Ann Arbor, MI
National Provider Identifier
1255475174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801006681 Issued in MI
Practice address
214 S Main St
Ann Arbor, MI 48104-2122
Phone
(734) 662-6300
Fax
(734) 662-3365
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801006681 MI Primary

Addresses

Primary practice location

214 S Main St
Ann Arbor, MI 48104-2122

Mailing address

214 S Main St
Ann Arbor, MI 48104-2122
Phone (734) 662-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000060 MI Practitioner - Clinical Social Worker 8426246547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huron Valley Consultation Center IncGroup PAC ID 5698761161, 16 clinicians

Practice addresses (Care Compare)

2750 S State St
Ann Arbor, MI 48104-6179
Phone (734) 662-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Huron Valley Consultation Center Inc CurrentSince Jan 1, 1995 Accepting new patients

Locations

2750 S State St
Ann Arbor, MI 48104
Phone (734) 662-1986

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255475174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 S MAIN ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042122",
            "telephone_number": "734-662-6300",
            "fax_number": "734-662-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 S MAIN ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042122",
            "telephone_number": "734-662-6300",
            "fax_number": "734-662-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAIRS",
        "first_name": "WALLI",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801006681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.