NPIMap

Organization Active NPI

The Waterford Partners Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Waterford, MI
National Provider Identifier
1578629242
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
636931 Issued in MI
Legal business name
THE WATERFORD PARTNERS CENTER, LLC
Practice address
5220 Highland Rd
Suite 100
Waterford, MI 48327-1913
Phone
(248) 461-2800
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Authorized official

Name
Mr. William L Carpenter Jr.
Title
Board Manager
Phone
(317) 621-7475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 636931 MI Primary

Addresses

Primary practice location

5220 Highland Rd
Suite 100
Waterford, MI 48327-1913

Mailing address

5220 Highland Rd
Suite 100
Waterford, MI 48327-1913

Other identifiers 1

IdentifierTypeStateIssuer
636931OtherMIMI STATE LICENSE NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1578629242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD",
            "address_2": "SUITE 100",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD",
            "address_2": "SUITE 100",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271913",
            "telephone_number": "248-461-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATERFORD PARTNERS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BOARD MANAGER",
        "authorized_official_telephone_number": "317-621-7475",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "636931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI STATE LICENSE NUMBER",
            "identifier": "636931",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.