NPIMap

Organization Active NPI

Canton Asthma & Allergy PC

  • Pediatric Allergy/Immunology Physician
  • Canton, MI
National Provider Identifier
1487715157
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
Legal business name
CANTON ASTHMA & ALLERGY PC
Practice address
1600 S Canton Center Rd Ste 360
Canton Asthma & Allergy
Canton, MI 48188-0004
Phone
(734) 394-2661
Fax
(734) 394-2666
NPI assigned
Dec 13, 2006
Last updated
Mar 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Authorized official

Name
Jacquelyn A Arzooyan
Title
Office Manager
Phone
(734) 394-2661

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Pediatric Allergy/Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0201X Primary

Addresses

Primary practice location

1600 S Canton Center Rd Ste 360
Canton Asthma & Allergy
Canton, MI 48188-0004

Mailing address

1600 S Canton Center Rd Ste 360
Canton Asthma & Allergy
Canton, MI 48188-0004
Phone (734) 394-2661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050628000379 MI Part B Supplier - Clinic/Group Practice 4082659230 Receives reassigned benefits from 2 practitioners
Practice locations: Canton, MI

National Provider Directory

National Provider Directory

Locations

1600 S Canton Center Rd
Ste 360
Canton, MI 48188
Phone (734) 349-2661

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1487715157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S CANTON CENTER RD STE 360",
            "address_2": "CANTON ASTHMA & ALLERGY",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481880004",
            "telephone_number": "734-394-2661",
            "fax_number": "734-394-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S CANTON CENTER RD STE 360",
            "address_2": "CANTON ASTHMA & ALLERGY",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481880004",
            "telephone_number": "734-394-2661",
            "fax_number": "734-394-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON ASTHMA & ALLERGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "ARZOOYAN",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "734-394-2661"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.