Active NPI
Susan Reeder, MD
- Internal Medicine Physician
- Dearborn, MI
National Provider Identifier
1578596482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301050494
- Practice address
- 15101 Ford Rd
Dearborn, MI 48126-4611 - Phone
- (313) 582-2769
- Fax
- (313) 846-7708
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301050494 | MI | Primary |
Addresses
Primary practice location
15101 Ford Rd
Dearborn, MI 48126-4611
Mailing address
701 Maiden Choice LN
Catonsville, MD 21228-5968
Phone (313) 582-2769
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04-30411 | Other | EVERCARE | |
| 1578596482 | Medicaid | MI | |
| 1108253541 | Other | BCBS OF MI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245801600000",
"number": "1578596482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 MAIDEN CHOICE LN",
"city": "CATONSVILLE",
"state": "MD",
"postal_code": "212285968",
"telephone_number": "313-582-2769",
"fax_number": "313-846-7708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15101 FORD RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481264611",
"telephone_number": "313-582-2769",
"fax_number": "313-846-7708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEDER",
"first_name": "SUSAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2009-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301050494",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "04-30411",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1578596482",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MI",
"identifier": "1108253541",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.