Individual provider Active NPI

Heather Ainsworth

  • Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1568833697
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3932331 Issued in MI
Practice address
25300 Lahser Rd
Southfield, MI 48033-5868
Phone
(248) 354-3222
NPI assigned
Oct 15, 2015
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

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
Nurse Practitioner 363L00000X 3932331 MI Primary

Addresses

Primary practice location

25300 Lahser Rd
Southfield, MI 48033-5868

Mailing address

31224 Shorecrest Dr
Apt 26302
Novi, MI 48377-1190

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
I20151106002184 MI Practitioner - Nurse Practitioner 9335459155 Reassigns benefits to 1 organization

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
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3932331MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Nurse Practitioner CurrentSince Jan 5, 2016 Accepting new patients
Henry Ford Health System CurrentSince Jan 5, 2016 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

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, 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": "1568833697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31224 SHORECREST DR",
            "address_2": "APT 26302",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483771190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25300 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480335868",
            "telephone_number": "248-354-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AINSWORTH",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "3932331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.