Pediatric Urology of Mi

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

031012 Issued in MI

Legal business name

PEDIATRIC UROLOGY OF MI

Practice address

2221 Livernois Rd Ste 103
Troy, MI 48083-1603

Phone

(248) 519-0305

Fax

(248) 519-0315

NPI assigned

Feb 15, 2008

Organization subpart

No

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

Authorized official

Name

Kim Workman

Title

Office Manager

Phone

(248) 519-0305

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1356519920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 LIVERNOIS RD STE 103",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831603",
            "telephone_number": "248-519-0305",
            "fax_number": "248-519-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 LIVERNOIS RD STE 103",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831603",
            "telephone_number": "248-519-0305",
            "fax_number": "248-519-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC UROLOGY OF MI",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "WORKMAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-519-0305"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": "MI",
            "license": "031012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F31834",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pearle Vision Inc
• Shanelle Nicole Pearse, DDS
• Charlotte Peck
• Pediatric Cardiology of Southeastren Michigan
• Pediatric Locum Care PLC
• Ann S Pekarek, APRN,BC
• Dawn Louise Pelino, OTR, CHT
• Amanda Marie Pelletier, NP
• Kristen Pelshaw
• Jennifer Lynne Penaranda, CCC-SLP

• Pediatric Urology Physician in Troy, MI
• Providers in Troy, MI by specialty
• Pediatric Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.