NPIMap

Organization Active NPI

William Beaumont Hospital

  • Family Medicine Physician
  • Royal Oak, MI
National Provider Identifier
1497205272
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILLIAM BEAUMONT HOSPITAL
Practice address
5150 Coolidge Hwy
Beaumont Fastcare Retail Medicine
Royal Oak, MI 48073-1001
Phone
(248) 655-3227
NPI assigned
Oct 5, 2016
Organization subpart
Yes
Parent organization
BEAUMONT FASTCARE RETAIL MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

5150 Coolidge Hwy
Beaumont Fastcare Retail Medicine
Royal Oak, MI 48073-1001

Mailing address

26901 Beaumont Blvd
Compliance
Southfield, MI 48033-4716
Phone (947) 522-1964

Other identifiers 2

IdentifierTypeStateIssuer
0F37078OtherMIBCBSM
0F359270OtherMIBCBSM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.beaumont.edu

National Provider Directory

National Provider Directory
Tax ID family
William Beauont Hospital118 organizations share this tax ID, including this one
Part of
William Beauont Hospital

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1497205272",
    "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": "480334716",
            "telephone_number": "947-522-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 COOLIDGE HWY",
            "address_2": "BEAUMONT FASTCARE RETAIL MEDICINE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731001",
            "telephone_number": "248-655-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BEAUMONT HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUMONT FASTCARE RETAIL MEDICINE",
        "enumeration_date": "2016-10-05",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F37078",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0F359270",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "5150 Coolidge Hwy",
            "address_2": "Beaumont Fastcare Retail Medicine",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480731001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.