NPIMap

Organization Active NPI

Regents of the University of Michigan

  • Sports Medicine (Internal Medicine) Physician
  • Brighton, MI
National Provider Identifier
1306251699
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
Legal business name
REGENTS OF THE UNIVERSITY OF MICHIGAN
Practice address
8001 Challis Road
Brighton, MI 48116
Phone
(810) 227-9510
NPI assigned
Jun 25, 2014
Last updated
Apr 30, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
REGENTS OF THE UNIVERSITY OF MICHIGANAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
David Christopher Miller, MDNPI 1629092713
Title
President
Phone
(734) 936-3568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X MI
Sports Medicine (Family Medicine) Physician 207QS0010X MI
Sports Medicine (Internal Medicine) Physician 207RS0010X MI Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MI
Pediatric Rheumatology Physician 2080P0216X MI
Pediatric Sports Medicine Physician 2080S0010X MI
Pediatric Sports Medicine Physician 2080S0010X MN
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X MI
Sports Medicine (Preventive Medicine) Physician 2083S0010X MI
Sports Medicine (Psychiatry & Neurology) Physician 2084S0010X MI

Addresses

Primary practice location

8001 Challis Road
Brighton, MI 48116

Mailing address

3621 S State St
Provider Enrollment
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000325 MI Part B Supplier - Clinic/Group Practice 3779496856 Receives reassigned benefits from 2,340 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Chelsea Internal Medici157 organizations share this tax ID, including this one
Part of
Chelsea Internal Medici

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1306251699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 CHALLIS ROAD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "48116",
            "telephone_number": "810-227-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN",
        "enumeration_date": "2014-06-25",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-936-3568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "2084S0010X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sports Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.