Wayne State University

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

4704104646 Issued in MI

Legal business name

WAYNE STATE UNIVERSITY

Practice address

3901 Chrysler Services Drive
Detroit, MI 48201

Phone

(313) 993-3434

NPI assigned

Dec 13, 2016

Last updated

Dec 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alireza Amirsadri, M.D.NPI 1457398059

Title

Chief Medical Officer

Phone

(313) 319-3973

Specialties & licenses 1

Addresses

Other names 1

• University Physicians Group Other name

Practitioners 2

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.

• Alireza Amirsadri, MD

  • Psychiatry Physician
  • Detroit, MI
  • NPI 1457398059
  Authorized official Same address or phone
• Judy Claire Paull, DNP, APRN

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Hilton Head Island, SC
  • NPI 1568905081
  NPD (past)

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1316481195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 STABLE GATE RD",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299261059",
            "telephone_number": "478-258-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CHRYSLER SERVICES DRIVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-993-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "AMIRSADRI",
        "authorized_official_first_name": "ALIREZA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "313-319-3973",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": "4704104646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Physicians Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wayne County Patient Care Management System
• Wayne J Joseph, D.D.S.,Ms,PC
• Wayne Pediatrics Inc.
• Wayne Physician Services PC
• Wayne State University
• Wayne State University
• Wayne State University Psychology Clinic
• Wayne State University School of Medicine
• Wayne State University School of Medicine
• Wayne State University Speech and Language Center

• Adult Mental Health Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.