NPIMap

Organization Active NPI

Womens Specialty Associates, P.C.

  • Obstetrics & Gynecology Physician
  • Grand Blanc, MI
National Provider Identifier
1366544579
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMENS SPECIALTY ASSOCIATES, P.C.
Practice address
3434 Regency Park Dr
Suite a
Grand Blanc, MI 48439
Phone
(810) 694-9400
Fax
(810) 694-9445
NPI assigned
Sep 1, 2006
Last updated
Oct 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Authorized official

Name
Dr. Richard Jeff Elsworth, DONPI 1407954589
Title
Vice President
Phone
(810) 694-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MI Primary

Addresses

Primary practice location

3434 Regency Park Dr
Suite a
Grand Blanc, MI 48439

Mailing address

3434 Regency Park Dr
Suite a
Grand Blanc, MI 48439
Phone (810) 694-9400

Other names 1

  • Flint Womens Clinic Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060308000613 MI Part B Supplier - Clinic/Group Practice 4284641713 Receives reassigned benefits from 6 practitioners
Practice locations: Grand Blanc, MI

National Provider Directory

National Provider Directory

Locations

1402 W Court St
Flint, MI 48503
Phone (810) 767-3220

3434 Regency Park Dr
Ste A
Grand Blanc, MI 48439
Phone (810) 694-9400

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1366544579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 REGENCY PARK DR",
            "address_2": "SUITE A",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "810-694-9400",
            "fax_number": "810-694-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 REGENCY PARK DR",
            "address_2": "SUITE A",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "810-694-9400",
            "fax_number": "810-694-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMENS SPECIALTY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "ELSWORTH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JEFF",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "810-694-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flint Womens Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.