Ascension Providence Hospital

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

ASCENSION PROVIDENCE HOSPITAL

Practice address

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Phone

(248) 849-3000

Fax

(248) 849-2244

NPI assigned

Apr 20, 2006

Organization subpart

No

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

Authorized official

Name

Sarah Starkel

Title

Supervisor, Enrollment

Phone

(248) 680-8206

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PH Physicians Assistants/Providence Hospital and Medical Centers Inc Other name

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1376508333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 LIVERNOIS RD",
            "address_2": "SUITE 500",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831215",
            "telephone_number": "248-680-8000",
            "fax_number": "248-680-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000",
            "fax_number": "248-849-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION PROVIDENCE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "STARKEL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "SUPERVISOR, ENROLLMENT",
        "authorized_official_telephone_number": "248-680-8206"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN #",
            "identifier": "0N89760",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PH Physicians Assistants/Providence Hospital and Medical Centers Inc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PH Physicians Assistants/Providence Hospital and Medical Centers Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ascend Home Health Care, Inc.
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• Ascension Medical Group Michigan
• Ascension Medical Group Michigan
• Ascension Providence Hospital
• Ascension Providence Hospital
• Ascension Providence Hospital
• Ascension Providence Hospital
• Ascension Providence Hospital

• Medical Physician Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.