Active NPI
Regents of the University of Michigan
- Urology Physician
- Midland, MI
National Provider Identifier
1255728606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Christopher Miller
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | |||
| Obstetrics Physician | 207VX0000X | |||
| Urology Physician | 208800000X | Primary | ||
| Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Urology Physician
- Ann Arbor, MI
- NPI 1437184884
O20031121000193
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Urology Physician
- Ann Arbor, MI
- NPI 1629092713
-
- Urology Physician
- Ann Arbor, MI
- NPI 1972828192
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.