Individual provider Active NPI

Clifford Patrick Loeckner, M.D.

  • Emergency Medicine Physician
  • Detroit, MI
National Provider Identifier
1417021924
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
045181 Issued in MI
Practice address
Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone
(313) 916-2436
NPI assigned
Nov 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 045181 MI Primary

Addresses

Primary practice location

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202

Mailing address

Henry Ford Health System
2799 West Grand Boulevard
Detroit, MI 48202
Phone (313) 916-2436

Other identifiers 2

IdentifierTypeStateIssuer
CL045181OtherCOMMERCIAL-COMMERCIAL NUMBER
CL045181OtherCHAMPUS-CHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
045181MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Sparrow Clinton Hospital CurrentSince May 1, 2016 Accepting new patients
Sparrow Clinton Hospital Emergency Medicine CurrentSince May 1, 2016 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince May 1, 2016 Accepting new patients
Henry Ford Health System Emergency Medicine CurrentSince May 1, 2016 Accepting new patients
Shorepointe Emergency Care Physicians PC Past Accepting new patients
Physician Healthcare Network, PC Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100

1 Ford Pl
Ste 1F
Detroit, MI 48202
Phone (313) 874-4907

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

159 Kercheval Ave
Grosse Pointe Farms, MI 48236
Phone (313) 640-1000

468 Cadieux Rd
Grosse Pointe Woods, MI 48230
Phone (313) 343-1000

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11357/brand/3/csg/1/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417021924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "2799 WEST GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOECKNER",
        "first_name": "CLIFFORD PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "045181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "CL045181",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "CL045181",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.