Independence Health LLC

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

Legal business name

INDEPENDENCE HEALTH LLC

Practice address

5757 Monclova Rd Ste 17
Maumee, OH 43537-1863

Phone

(419) 891-8003

Fax

(419) 891-8048

NPI assigned

Feb 16, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Mike M Ariss, MPH, EDD

Title

Ceo

Phone

(248) 904-6237

Specialties & licenses 1

Addresses

Other names 1

• Independence Health Employer Services LLC Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1477208643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28442 E RIVER RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 MONCLOVA RD STE 17",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371863",
            "telephone_number": "419-891-8003",
            "fax_number": "419-891-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "ARISS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-904-6237",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH, EDD"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Independence Health Employer Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.