Organization Active NPI

Ann Marie Bradley Enterprises Inc

  • Community/Behavioral Health Agency
  • Plymouth, MI
National Provider Identifier
1447510060
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
AB059736 Issued in MI
Legal business name
ANN MARIE BRADLEY ENTERPRISES INC
Practice address
190 N Main St
Plymouth, MI 48170-1236
Phone
(734) 416-3341
Fax
(734) 416-3345
NPI assigned
May 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Shelley Taglione, BILLING CEO
Title
Billing Ceo
Phone
(734) 414-0754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X AB059736 MI Primary

Addresses

Primary practice location

190 N Main St
Plymouth, MI 48170-1236

Mailing address

190 N Main St
Plymouth, MI 48170-1236
Phone (734) 416-3341

Other identifiers 1

IdentifierTypeStateIssuer
8008911330OtherMIBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120531000105 MI Part B Supplier - Clinic/Group Practice 1759544760 Receives reassigned benefits from 1 practitioner
Practice locations: Plymouth, MI

National Provider Directory

National Provider Directory

Locations

409 Plymouth Rd
Plymouth, MI 48170
Phone (734) 306-6263

190 N Main St
Plymouth, MI 48170
Phone (734) 416-3341

477 S Main St
Plymouth, MI 48170
Phone (734) 416-3341

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1447510060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 N MAIN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701236",
            "telephone_number": "734-416-3341",
            "fax_number": "734-416-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N MAIN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701236",
            "telephone_number": "734-416-3341",
            "fax_number": "734-416-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN MARIE BRADLEY ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-17",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "TAGLIONE",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "BILLING CEO",
        "authorized_official_telephone_number": "734-414-0754",
        "authorized_official_credential": "BILLING CEO"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "AB059736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8008911330",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.