NPIMap

Organization Active NPI

Botsford General Hospital

Doing business as Botsford Pediatric Assoc (NP)

  • Pediatric Registered Nurse
  • Farmington, MI
National Provider Identifier
1417134149
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
Legal business name
BOTSFORD GENERAL HOSPITAL
Doing business as
Botsford Pediatric Assoc (NP)
Practice address
23133 Orchard Lake Rd
Suite 100
Farmington, MI 48336-3268
Phone
(248) 477-0100
Fax
(248) 477-6153
NPI assigned
Jan 24, 2008
Last updated
Aug 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BOTSFORD GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Authorized official

Name
Lesley Willbrandt
Title
Director Shared Services
Phone
(947) 522-1911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X NU Primary

Addresses

Primary practice location

23133 Orchard Lake Rd
Suite 100
Farmington, MI 48336-3268

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other identifiers 1

IdentifierTypeStateIssuer
500F335250OtherMIBCBS

Other names 1

  • Botsford Pediatric Assoc (NP) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Botsford General HSP20 organizations share this tax ID, including this one
Part of
Botsford General HSP

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1417134149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23133 ORCHARD LAKE RD",
            "address_2": "SUITE 100",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483363268",
            "telephone_number": "248-477-0100",
            "fax_number": "248-477-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTSFORD GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOTSFORD GENERAL HOSPITAL",
        "enumeration_date": "2008-01-24",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "WILLBRANDT",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "DIRECTOR SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-1911"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "500F335250",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Botsford Pediatric Assoc (NP)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Botsford Pediatric Assoc (NP)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.