NPIMap

Organization Active NPI

Larry Weiss DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Detroit, MI
National Provider Identifier
1457385841
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901000807 Issued in MI
Legal business name
LARRY WEISS DPM PC
Practice address
17421 Greenfield
Detroit, MI 48235
Phone
(313) 273-7091
Fax
(313) 273-7694
NPI assigned
Jul 10, 2006
Last updated
Feb 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Debra Hillson
Title
Billing Agent
Phone
(248) 569-5960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901000807 MI Primary

Addresses

Primary practice location

17421 Greenfield
Detroit, MI 48235

Mailing address

17421 Greenfield
Detroit, MI 48235
Phone (313) 273-7091

Other identifiers 1

IdentifierTypeStateIssuer
1485013MedicaidMI

National Provider Directory

National Provider Directory

Locations

17421 Greenfield Rd
Detroit, MI 48235
Phone (313) 273-7091

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1457385841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17421 GREENFIELD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-273-7091",
            "fax_number": "313-273-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17421 GREENFIELD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-273-7091",
            "fax_number": "313-273-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY WEISS DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "HILLSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "248-569-5960"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901000807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1485013",
            "state": "MI"
        }
    ],
    "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 Feb 21, 2008; 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.