Individual provider Active NPI

Fred Woolley Stelson, M.D.

  • Psychiatry Physician
  • Ann Arbor, MI
National Provider Identifier
1275718553
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301056585 Issued in MI
Practice address
559 Waymarket Dr
Ann Arbor, MI 48103-6621
Phone
(734) 277-2809
NPI assigned
Jan 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 4301056585 MI
Child & Adolescent Psychiatry Physician 2084P0804X 4301056585 MI
Psychiatry Physician 2084P0800X 4301056585 MI Primary

Addresses

Primary practice location

559 Waymarket Dr
Ann Arbor, MI 48103-6621

Mailing address

559 Waymarket Dr
Ann Arbor, MI 48103-6621
Phone (734) 496-0157

Other practice location 1

910 Lakeshore Boulevard
Ypsilanti, MI 48198
Phone (734) 277-2809

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080419000028 MI Practitioner - PsychiatryPractitioner - Pain Management 3274525241 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301056585MIMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Zion Healing Center of Grand Rapids LLC Psychiatry CurrentSince Sep 4, 2025 Accepting new patients
Fred W. Stelson, M.D. PLC Psychiatry CurrentSince Feb 21, 2025 Accepting new patients
Kenneth L Land PC Past Accepting new patients
State of Michigan Office of Financial Management Past Accepting new patients
Patricia J Lafave P H D & Associates P C PastSince Jun 1, 2017 Accepting new patients

Locations

3501 Lake Eastbrook Blvd SE
Ste 150
Grand Rapids, MI 49546
Phone (616) 460-1168

Interoperability endpoints

  • Direct secure messaging: fredw.stelson.fred@159998.advancedmd-direct.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1275718553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 WAYMARKET DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036621",
            "telephone_number": "734-496-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 WAYMARKET DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036621",
            "telephone_number": "734-277-2809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Lakeshore Boulevard",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "48198",
            "country_code": "US",
            "telephone_number": "734-277-2809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STELSON",
        "first_name": "FRED",
        "middle_name": "WOOLLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-04",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MI",
            "license": "4301056585",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301056585",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301056585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.