Individual provider Active NPI

Christina Coulbeck, FNP

  • Family Nurse Practitioner
  • Novi, MI
National Provider Identifier
1508237637
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704208647 Issued in MI
Practice address
47601 Grand River Ave
Novi, MI 48374-1233
Phone
(248) 465-4100
NPI assigned
Oct 15, 2015
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704208647 MI Primary

Addresses

Primary practice location

47601 Grand River Ave
Novi, MI 48374-1233

Mailing address

47601 Grand River Ave
Novi, MI 48374-1233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160115000468 MI Practitioner - Nurse Practitioner 1759684335 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Emergency Physicians PCGroup PAC ID 6709798325, 173 clinicians

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3331

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital CurrentSince Nov 5, 2015 Accepting new patients
Independent Observation Physicians PLLC CurrentSince Dec 25, 2018 Accepting new patients
Independent Emergency Physicians, P.C. CurrentSince Dec 25, 2018 Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Nov 5, 2015 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients

Locations

36750 26 Mile Rd
Chesterfield, MI 48047
Phone (586) 879-2000

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

4100 S River Rd
East China, MI 48054
Phone (810) 329-6677

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

17700 23 Mile Rd
Macomb, MI 48044
Phone (586) 416-7500

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

47601 Grand River Ave
Rm D101
Novi, MI 48374

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: ccoulbeck1123920@direct.hfhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1508237637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741233",
            "telephone_number": "248-465-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULBECK",
        "first_name": "CHRISTINA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704208647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.