Organization Active NPI

Regents of the University of Michigan

  • Urology Physician
  • Midland, MI
National Provider Identifier
1255728606
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
REGENTS OF THE UNIVERSITY OF MICHIGAN
Doing business as
University of Michigan Health
Practice address
4201 Campus Ridge Dr Ste 3400
Midland, MI 48640-6132
Phone
(989) 839-1386
NPI assigned
Apr 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
David Christopher MillerNPI 1629092713
Title
President
Phone
(734) 936-3568

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2088F0040X

Addresses

Primary practice location

4201 Campus Ridge Dr Ste 3400
Midland, MI 48640-6132

Mailing address

3621 S State St.
Provider Enrollment
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other names 1

  • University of Michigan Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000193 MI Part B Supplier - Clinic/Group Practice 3779496856 Receives reassigned benefits from 72 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ann Arbor, MI; Northville, MI; Muskegon, MI; Livonia, MI; Chelsea, MI; Brighton, MI

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1255728606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST.",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 CAMPUS RIDGE DR STE 3400",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406132",
            "telephone_number": "989-839-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-936-3568"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2088F0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Michigan Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Michigan Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.