NPIMap

Organization Active NPI

CCS-Oakland LLC

  • Perfusionist
  • Plymouth, MI
National Provider Identifier
1306661616
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PerfusionistTaxonomy code 242T00000X
Legal business name
CCS-OAKLAND LLC
Doing business as
CCS-Oakland LLC
Practice address
45211 Helm St
Plymouth, MI 48170-6023
Phone
(734) 525-9712
NPI assigned
Nov 21, 2024
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Patricia Fanelli, CCPNPI 1316272701
Title
President
Phone
(734) 525-9712

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PerfusionistGroup: 193200000X MULTI-SPECIALTY GROUP 242T00000X Primary
Other Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246Z00000X
Health Information TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 247000000X

Addresses

Primary practice location

45211 Helm St
Plymouth, MI 48170-6023

Mailing address

45211 Helm St
Plymouth, MI 48170-6023
Phone (734) 525-9712

Other names 1

  • CCS-Oakland LLC Doing business as

National Provider Directory

National Provider Directory

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": "1732147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1306661616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45211 HELM ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706023",
            "telephone_number": "734-525-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45211 HELM ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706023",
            "telephone_number": "734-525-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCS-OAKLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "FANELLI",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-525-9712",
        "authorized_official_credential": "CCP"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Perfusionist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Health Information",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCS-Oakland LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.