Individual provider Active NPI

Carla L Guggenheim, DO

  • Rheumatology Physician
  • Lansing, MI
National Provider Identifier
1477562643
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
CG010463 Issued in MI
Practice address
1106 N Cedar St
Suite 2a
Lansing, MI 48906-5334
Phone
(517) 267-0107
Fax
(517) 267-9523
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X CG010463 MI Primary

Addresses

Primary practice location

1106 N Cedar St
Suite 2a
Lansing, MI 48906-5334

Mailing address

1106 N Cedar St
Suite 2a
Lansing, MI 48906-5334
Phone (517) 267-0107

Other identifiers 5

IdentifierTypeStateIssuer
1153302345OtherMIMICHIGAN BLUE SHIELD
CG010463OtherMISTATE LICENSE NUMBER
1004432OtherMIMCLAREN HEALTH PLAN
4233584MedicaidMI
3200009OtherMIPHYSICIANS HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
CG010463MIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitative Care, PC Past Accepting new patients

Organizations & group practices 1

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1477562643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 N CEDAR ST",
            "address_2": "SUITE 2A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489065334",
            "telephone_number": "517-267-0107",
            "fax_number": "517-267-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 N CEDAR ST",
            "address_2": "SUITE 2A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489065334",
            "telephone_number": "517-267-0107",
            "fax_number": "517-267-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGGENHEIM",
        "first_name": "CARLA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "CG010463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BLUE SHIELD",
            "identifier": "1153302345",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "CG010463",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1004432",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4233584",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "3200009",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.