My Second Home Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2732113 Issued in MI

Legal business name

MY SECOND HOME PEDIATRICS PLLC

Practice address

31000 Telegraph Rd
Sutie 100
Bingham Farms, MI 48025-4360

Phone

(248) 865-0030

NPI assigned

Jun 25, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kalpana Shah, M.D.

Title

Member

Phone

(248) 865-0030

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1308960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309737600000",
    "number": "1285920462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD",
            "address_2": "SUITE 100",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254360",
            "telephone_number": "248-865-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD",
            "address_2": "SUTIE 100",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254360",
            "telephone_number": "248-865-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY SECOND HOME PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-25",
        "last_updated": "2011-07-04",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KALPANA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "248-865-0030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "2732113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3289496",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Rose Murray, CPRC
• Chelsey Paige Murray
• Jack Muschong
• Bilal Mustaquim
• Mominah Mustaquim
• Kelly Jean Myers, PSY.D.
• Scott Myers, CRNA
• Rhiannon Joy Nadratowski
• Cynthia Nagel, CRNA
• Debra Nagy, LP

• Pediatrics Physician in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Pediatrics Physician in Michigan

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