Individual provider Active NPI

Rosanne Wilkinson, PA-C

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1437127008
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003280 Issued in MI
Practice address
22101 Moross Rd
Sutie 132 PB-1
Detroit, MI 48236-2148
Phone
(313) 343-3150
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
Yes

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
Physician Assistant 363A00000X 5601003280 MI Primary

Addresses

Primary practice location

22101 Moross Rd
Sutie 132 PB-1
Detroit, MI 48236-2148

Mailing address

22101 Moross Road
PB-1 Suite 132
Detroit, MI 48236
Phone (313) 343-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040313000113 MI Practitioner - Physician Assistant 6103715511 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601003280MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince May 9, 2009 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince May 9, 2009 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Innovation Medicine, PLLC Past Accepting new patients
Movement Orthopedics PastSince Jun 16, 2024 Accepting new patients
Movement Orthopedics Past Accepting new patients

Locations

22101 Moross Rd
Ste 132
Detroit, MI 48236
Phone (313) 343-3150

22101 Moross Rd
Ph
Detroit, MI 48236

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

3601 W 13 Mile Rd
Royal Oak, MI 48073

Interoperability endpoints

  • Direct secure messaging: rosanne.wilkinson.1@29663.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437127008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22101 MOROSS ROAD",
            "address_2": "PB-1 SUITE 132",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-343-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "address_2": "SUTIE 132 PB-1",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "ROSANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.