University Physician Group

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

UNIVERSITY PHYSICIAN GROUP

Practice address

4201 Saint Antoine St
Suite 4C
Detroit, MI 48201-2153

Phone

(313) 745-4525

NPI assigned

Jun 7, 2006

Organization subpart

No

Name

Mr. Jeffery P Kohlitz

Title

Chief Financial Officer

Phone

(248) 581-5930

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea J Abatemarco, RD

  • Registered Dietitian
  • Detroit, MI
  • NPI 1104073162

  Dietitian, Registered

  NPD (past)
• Shirley Dunlap, RD

  • Registered Dietitian
  • Detroit, MI
  • NPI 1427091131

  Dietitian, Registered

  NPD (past)
• Joan Trute, MA, RD

  • Registered Dietitian
  • Grosse Pointe Woods, MI
  • NPI 1982868261

  Dietitian, Registered

  NPD (past)

• Wayne State University Physician Group Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 26, 2016.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1265472575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E. MAPLE RD.",
            "address_2": "SUITE 400-CREDENTIALING DEPT.",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "248-581-5973",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "SUITE 4C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PHYSICIAN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "KOHLITZ",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "248-581-5930",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP # - RD",
            "identifier": "0P32130",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne State University Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• University Pediatricians
• University Pediatricians
• University Pediatricians
• University Physician Group
• University Physician Group
• University Physician Group
• University Physician Group
• University Physician Group
• University Physician Group
• University Physician Group

• All providers in Detroit, MI
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.