Himaja Gummadi, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301070128 Issued in MI

Practice address

30901 Palmer Rd
Westland, MI 48186-9529

Phone

(734) 367-8403

Fax

(734) 722-9524

NPI assigned

Jul 15, 2006

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 identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of Michigan Office of Financial Management

  dba State of Michigan

  • Psychiatric Hospital
  • Westland, MI
  • NPI 1508883299
  Medicare reassignment NPD
• State of Michigan Office of Financial Management

  dba Michigan Veteran Homes at Chesterfield Twp

  • Skilled Nursing Facility
  • Chesterfield, MI
  • NPI 1497342653
  NPD

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1265458624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 QUEEN ANNE DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874682",
            "telephone_number": "734-397-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30901 PALMER RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481869529",
            "telephone_number": "734-367-8403",
            "fax_number": "734-722-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMMADI",
        "first_name": "HIMAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301070128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GR#",
            "identifier": "260Q26259",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4867342",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "HG070108",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WRPH",
            "identifier": "1508883299",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "2600052028",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Joseph Gregosky, BS CADC-D
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• Millicent Adjoa Gyamfuah
• H & a Health Pharmacy LLC

• Psychiatry Physician in Westland, MI
• Providers in Westland, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.