NPIMap

Organization Active NPI

Michigan Headache & Neurological Institute PC

  • Psychologist
  • Ann Arbor, MI
National Provider Identifier
1376638528
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MICHIGAN HEADACHE & NEUROLOGICAL INSTITUTE PC
Practice address
3120 Professional Dr
Ann Arbor, MI 48104-5131
Phone
(734) 677-6000
Fax
(734) 677-2422
NPI assigned
Oct 4, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Scott F Madden, FACHE
Title
Vice President & Administrator
Phone
(734) 677-6000

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20031211000501 MI Part B Supplier - Clinic/Group Practice 5597661975 Receives reassigned benefits from 2 practitioners
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

3120 Professional Dr
Ann Arbor, MI 48104-5131

Mailing address

3120 Professional Dr
Ann Arbor, MI 48104-5131
Phone (734) 677-6000

Other names 1

NPPES NPI Registry
  • Michigan Head-Pain & Neurological Institute, PC Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 12, 2019.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1376638528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 PROFESSIONAL DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045131",
            "telephone_number": "734-677-6000",
            "fax_number": "734-677-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 PROFESSIONAL DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045131",
            "telephone_number": "734-677-6000",
            "fax_number": "734-677-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN HEADACHE & NEUROLOGICAL INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "MADDEN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT & ADMINISTRATOR",
        "authorized_official_telephone_number": "734-677-6000",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Head-Pain & Neurological Institute, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michigan Head-Pain & Neurological Institute, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.