NPIMap

Organization Active NPI

Oakwood Healthcare, Inc.

Doing business as Beaumont Hospital - Taylor

  • Diagnostic Radiology Physician
  • Taylor, MI
National Provider Identifier
1306850854
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
820250 Issued in MI
Legal business name
OAKWOOD HEALTHCARE, INC.
Doing business as
Beaumont Hospital - Taylor
Practice address
10000 Telegraph Rd
Taylor, MI 48180-3330
Phone
(313) 295-5000
Fax
(313) 295-5085
NPI assigned
Jul 28, 2006
Last updated
Oct 12, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
OAKWOOD HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 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
Diagnostic Radiology Physician 2085R0202X 820250 MI Primary

Addresses

Primary practice location

10000 Telegraph Rd
Taylor, MI 48180-3330

Mailing address

26901 Beaumont Blvd.
Compliance
Southfield, MI 48033-4617
Phone (947) 522-1963

Other identifiers 5

IdentifierTypeStateIssuer
110242874OtherMIRAIL ROAD PROFESSIONAL
OP821177OtherMIM-CARE PROFESSIONAL
113074760MedicaidMI
00000001147AOtherMICAPE HEALTH PROFESSIONAL
0Q24603OtherMIBSHIELD/BCN PROFESSIONAL

Other names 1

  • Beaumont Hospital - Taylor Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031205000505 MI Part B Supplier - Clinic/Group Practice 1254236839 Receives reassigned benefits from 33 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dearborn, MI; Taylor, MI; Trenton, MI; Wayne, MI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Peter Zahos MD28 organizations share this tax ID, including this one
Part of
Peter Zahos MD

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

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": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1306850854",
    "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": "480334617",
            "telephone_number": "947-522-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 TELEGRAPH RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803330",
            "telephone_number": "313-295-5000",
            "fax_number": "313-295-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKWOOD HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAKWOOD HEALTHCARE, INC.",
        "enumeration_date": "2006-07-28",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "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": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "820250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD PROFESSIONAL",
            "identifier": "110242874",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE PROFESSIONAL",
            "identifier": "OP821177",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113074760",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH PROFESSIONAL",
            "identifier": "00000001147A",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSHIELD/BCN PROFESSIONAL",
            "identifier": "0Q24603",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "10000 Telegraph Rd",
            "city": "Taylor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481803330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Beaumont Hospital - Taylor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beaumont Hospital - Taylor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.