North Woodward Capsule Imaging, LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301038180 Issued in MI

Legal business name

NORTH WOODWARD CAPSULE IMAGING, LLC

Practice address

26771 W 12 Mile Rd
Ste 106
Southfield, MI 48034-1539

Phone

(248) 351-0552

Fax

(248) 746-9588

NPI assigned

Aug 17, 2006

Last updated

Aug 22, 2020By 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

Mrs. Ana Maria Mathis

Title

Office Manager

Phone

(248) 351-0552

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326151960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26771 W 12 MILE RD",
            "address_2": "STE 106",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341539",
            "telephone_number": "248-351-0552",
            "fax_number": "248-746-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26771 W 12 MILE RD",
            "address_2": "STE 106",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341539",
            "telephone_number": "248-351-0552",
            "fax_number": "248-746-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH WOODWARD CAPSULE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-351-0552",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301038180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2733386",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.