NPIMap

Organization Active NPI

Botsford General Hosptial

  • Obstetrics & Gynecology Physician
  • Livonia, MI
National Provider Identifier
1487698247
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BOTSFORD GENERAL HOSPTIAL
Practice address
28711 8 Mile Rd
Suite C
Livonia, MI 48152-2040
Phone
(248) 474-4590
Fax
(248) 888-9127
NPI assigned
Jun 15, 2006
Organization subpart
Yes
Parent organization
BOTSFORD GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Authorized official

Name
Lesley Willbrandt
Title
Director Shared Services
Phone
(947) 522-1911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

28711 8 Mile Rd
Suite C
Livonia, MI 48152-2040

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other identifiers 1

IdentifierTypeStateIssuer
OF37116OtherMIBLUE CROSS

Other names 1

  • Comprehensive OBGYN Livonia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031111000592 MI Part B Supplier - Clinic/Group Practice 2668385238 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Novi, MI; Redford, MI; Livonia, MI; Farmington Hills, MI; Dearborn HTS, MI
O20031112000174 MI Part B Supplier - Clinic/Group Practice 2668385238 Receives reassigned benefits from 10 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Livonia, MI; Farmington Hills, MI; Detroit, MI
O20031112000329 MI Part B Supplier - Clinic/Group Practice 2668385238 Receives reassigned benefits from 10 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Farmington, MI; Farmington Hills, MI

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
ER Phys-Botsford Gen Ho

Locations

28711 8 Mile Rd
Ste B
Livonia, MI 48152
Phone (248) 482-8830

28711 8 Mile Rd
Ste C
Livonia, MI 48152
Phone (248) 474-4590

39475 Lewis Dr
Ste 270
Novi, MI 48377
Phone (248) 324-2161

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1487698247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28711 8 MILE RD",
            "address_2": "SUITE C",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522040",
            "telephone_number": "248-474-4590",
            "fax_number": "248-888-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTSFORD GENERAL HOSPTIAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOTSFORD GENERAL HOSPITAL",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "WILLBRANDT",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "DIRECTOR SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-1911"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "OF37116",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive OBGYN Livonia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Comprehensive OBGYN Livonia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.