Individual provider Active NPI

Chamkaur Gill, NP

  • Nurse Practitioner
  • Farmington Hills, MI
National Provider Identifier
1477970531
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704157367 Issued in MI
Practice address
39353 Heatherbrook Dr
Farmington Hills, MI 48331-2918
Phone
(313) 565-6663
Fax
(313) 565-6632
NPI assigned
Mar 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704157367 MI Primary

Addresses

Primary practice location

39353 Heatherbrook Dr
Farmington Hills, MI 48331-2918

Mailing address

24224 Joy Rd
Suite 101
Redford, MI 48239-1215
Phone (313) 565-6663

Other identifiers 1

IdentifierTypeStateIssuer
1477970531MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704157367MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nabil Metwally MD PC CurrentSince Mar 28, 2015 Accepting new patients

Locations

24224 Joy Rd
Ste 101
Redford, MI 48239
Phone (248) 305-6154

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1477970531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24224 JOY RD",
            "address_2": "SUITE 101",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391215",
            "telephone_number": "313-565-6663",
            "fax_number": "313-565-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39353 HEATHERBROOK DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483312918",
            "telephone_number": "313-565-6663",
            "fax_number": "313-565-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "CHAMKAUR",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704157367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477970531",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.