Active NPI
Gwendolyn D Bush
- Adult Day Care Clinic/Center
- Southfield, MI
National Provider Identifier
1518548601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Practice address
- 23195 Riverside Dr
Southfield, MI 48033-7301 - Phone
- (954) 806-9411
- NPI assigned
- Apr 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
23195 Riverside Dr
Southfield, MI 48033-7301
Mailing address
23195 Riverside Dr
Southfield, MI 48033-7301
Phone (954) 806-9411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9521503 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.waydanconsultingservices.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waydan Consulting Services | Current | Accepting new patients | |
| Baseline Human and Health Services | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- In Home Supportive Care Agency
- Oak Park, MI
- NPI 1275352080
-
- Home Health Aide
- Farmington Hills, MI
- NPI 1619558723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1518548601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23195 RIVERSIDE DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480337301",
"telephone_number": "954-806-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23195 RIVERSIDE DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480337301",
"telephone_number": "954-806-9411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "GWENDOLYN",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9521503",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.waydanconsultingservices.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "23195 Riverside Dr",
"city": "Southfield",
"state": "MI",
"country_code": "US",
"postal_code": "480337301",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.