Active NPI
Christina Doulaverakis, M.D.
- Family Medicine Physician
- Southfield, MI
National Provider Identifier
1275916231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301107303
- Practice address
- 22250 Providence Dr
Suite 500
Southfield, MI 48075-4825 - Phone
- (248) 849-3441
- NPI assigned
- Jul 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301107303 | MI | Primary |
Addresses
Primary practice location
22250 Providence Dr
Suite 500
Southfield, MI 48075-4825
Mailing address
3871 Howard Ave
Windsor, ONT N9G 1N6
CA
Phone (226) 246-4627
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301107303 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436313600000",
"number": "1275916231",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "3871 HOWARD AVE",
"city": "WINDSOR",
"state": "ONT",
"postal_code": "N9G 1N6",
"telephone_number": "226-246-4627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22250 PROVIDENCE DR",
"address_2": "SUITE 500",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754825",
"telephone_number": "248-849-3441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOULAVERAKIS",
"first_name": "CHRISTINA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-08",
"last_updated": "2015-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301107303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.