Organization Active NPI

Downriver Neurology PC

  • Neurology Physician
  • Riverview, MI
National Provider Identifier
1275728107
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301078496 Issued in MI
Legal business name
DOWNRIVER NEUROLOGY PC
Practice address
17515 Fort St
Riverview, MI 48193-6630
Phone
(734) 225-7770
NPI assigned
Sep 13, 2007
Last updated
Apr 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Authorized official

Name
Dr. Christopher James Whitty, M.D., PH.D.NPI 1457339574
Title
President
Phone
(734) 225-7770

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 4301078496 MI Primary

Addresses

Primary practice location

17515 Fort St
Riverview, MI 48193-6630

Mailing address

17515 Fort St
Riverview, MI 48193-6630
Phone (734) 225-7770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050811000473 MI Part B Supplier - Clinic/Group Practice 3476582214 Receives reassigned benefits from 1 practitioner
Practice locations: Riverview, MI

National Provider Directory

National Provider Directory

Locations

17515 Fort St
Riverview, MI 48193
Phone (734) 225-7770

1650 Fort St
Ste C
Trenton, MI 48183
Phone (734) 676-3606

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDFHBA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1275728107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17515 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481936630",
            "telephone_number": "734-225-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17515 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481936630",
            "telephone_number": "734-225-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNRIVER NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "WHITTY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-225-7770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301078496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.