NPIMap

Organization Active NPI

Oakwood Healthcare Group III, LLC

  • Certified Registered Nurse Anesthetist
  • Dearborn, MI
National Provider Identifier
1295776052
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
OAKWOOD HEALTHCARE GROUP III, LLC
Practice address
18101 Oakwood Blvd
Department of Anesthesia
Dearborn, MI 48124-4089
Phone
(313) 593-7820
Fax
(313) 593-8894
NPI assigned
Jun 10, 2006
Last updated
Oct 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Authorized official

Name
Lee Ann Odom
Title
President Shared Services
Phone
(947) 522-3326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Department of Anesthesia
Dearborn, MI 48124-4089

Mailing address

26901 Beaumont Blvd
Compliance
Southfield, MI 48033-3849
Phone (947) 522-1964

Other identifiers 3

IdentifierTypeStateIssuer
136191400OtherMIUSDOL
430H217720OtherMIBCBS
AN820022OtherMIMCARE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1295776052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "address_2": "COMPLIANCE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7820",
            "fax_number": "313-593-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKWOOD HEALTHCARE GROUP III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-3326"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDOL",
            "identifier": "136191400",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "430H217720",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "AN820022",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.