Individual provider Active NPI

Christopher Emil Hermann, NP-C

  • Adult Health Nurse Practitioner
  • Dearborn Heights, MI
National Provider Identifier
1356344121
Registry record updated Jan 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704128568 Issued in MI
Practice address
6592 N Silvery LN
Dearborn Heights, MI 48127-2170
Phone
(313) 316-4236
Fax
(313) 262-1927
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704128568 MI Primary

Addresses

Primary practice location

6592 N Silvery LN
Dearborn Heights, MI 48127-2170

Mailing address

6592 N Silvery LN
Dearborn Heights, MI 48127-2170
Phone (313) 274-1088

Other identifiers 1

IdentifierTypeStateIssuer
4359479MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610755200000",
    "number": "1356344121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6592 N SILVERY LN",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272170",
            "telephone_number": "313-274-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6592 N SILVERY LN",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272170",
            "telephone_number": "313-316-4236",
            "fax_number": "313-262-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANN",
        "first_name": "CHRISTOPHER",
        "middle_name": "EMIL",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-01-16",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704128568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4359479",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.