Active NPI
Cori Danielle Chase, D.O.
- Psychiatry Physician
- Detroit, MI
National Provider Identifier
1376840256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- BM 25495099760
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (586) 263-2614
- NPI assigned
- Feb 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | BM 25495099760 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
13128 Borgman Ave
Huntington Woods, MI 48070-1004
Phone (313) 595-2354
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BM 25495099760 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovation Medicine, PLLC | Past | Accepting new patients | |
| Community Mental Health for Central Michigan | Psychiatry | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
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- Mt Pleasant, MI
- NPI 1609412840
Psychiatry
-
- Internal Medicine Physician
- Roseville, MI
- NPI 1720511405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1376840256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13128 BORGMAN AVE",
"city": "HUNTINGTON WOODS",
"state": "MI",
"postal_code": "480701004",
"telephone_number": "313-595-2354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "586-263-2614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHASE",
"first_name": "CORI",
"middle_name": "DANIELLE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-11",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "BM 25495099760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.