NPIMap

Organization Active NPI

BWC Brighton LLC

Doing business as Blossom Children's Center-Brighton

  • Speech-Language Pathologist
  • Brighton, MI
National Provider Identifier
1366282980
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
BWC BRIGHTON LLC
Doing business as
Blossom Children's Center-Brighton
Practice address
8175 Movie Dr
Brighton, MI 48116-7444
Phone
(248) 277-3005
NPI assigned
May 30, 2024
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Ziad Koza
Title
Ceo and Founder
Phone
(248) 860-6212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

8175 Movie Dr
Brighton, MI 48116-7444

Mailing address

44225 W 12 Mile Rd Ste C-106
Novi, MI 48377-2640

Other names 1

  • Blossom Children's Center-Brighton Doing business as

National Provider Directory

National Provider Directory

Locations

44225 W Twelve Mile Rd
Ste C-106
Novi, MI 48377
Phone (248) 277-3005

Practitioners & affiliated clinicians

Practitioners 44

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.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1366282980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44225 W 12 MILE RD STE C-106",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 MOVIE DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481167444",
            "telephone_number": "248-277-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BWC BRIGHTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "KOZA",
        "authorized_official_first_name": "ZIAD",
        "authorized_official_title_or_position": "CEO AND FOUNDER",
        "authorized_official_telephone_number": "248-860-6212"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blossom Children's Center-Brighton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.