NPIMap

William Beaumont Hospital

Organization Active NPI Community Based Hospice Care Agency · Madison Heights, MI

NPI 1477587186 · NPPES record last updated Oct 1, 2021

Key facts

NPI
1477587186
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
Legal business name
WILLIAM BEAUMONT HOSPITAL
Practice address
1410 E 14 Mile Rd
Madison Heights, MI 48071-1541
Phone
(248) 743-9400
Fax
(248) 743-9111
NPI assigned
Jul 10, 2006
Organization subpart
No

Authorized official

Name
Lee Ann Odom
Title
President Shared Services
Phone
(947) 522-3326

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Medicare participation

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

Change-of-ownership history

DateEventCounterparty
Jan 1, 2019 Change of Ownership
This provider was the seller		 Beaumont Hospice
CCN 231574 · MI · NPI 1851865786

National Provider Directory

Tax ID family
William Beauont Hospital (118 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Yes

Addresses

Primary practice location

1410 E 14 Mile Rd
Madison Heights, MI 48071-1541

Mailing address

26901 Beaumont Blvd
Compliance
Southfield, MI 48033-3849
Phone (947) 522-1964

Other identifiers

IdentifierTypeStateIssuer
08775OtherMIBCBS PROVIDER ID#
3442928MedicaidMI

Other names

  • Beaumont Hospice Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.beaumont.edu

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 1, 2021.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1477587186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "address_2": "COMPLIANCE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E 14 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711541",
            "telephone_number": "248-743-9400",
            "fax_number": "248-743-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BEAUMONT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-3326"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID#",
            "identifier": "08775",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3442928",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "1410 E 14 Mile Rd",
            "city": "Madison Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480711541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Beaumont Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beaumont Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison Heights, MI

All providers in Madison Heights, MI · Community Based Hospice Care Agency in Michigan

Sources for this page

Verify at the official NPI Registry.