NPIMap

Organization Active NPI

Shahnaz Ali, M.D. PLLC

Doing business as Age Management & Hormone Balance Center

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1598088171
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301076867 Issued in MI
Legal business name
SHAHNAZ ALI, M.D. PLLC
Doing business as
Age Management & Hormone Balance Center
Practice address
1787 Grand Ridge CT NE
Ste 202
Grand Rapids, MI 49525-7042
Phone
(616) 808-2695
Fax
(616) 808-2697
NPI assigned
Mar 10, 2010
Last updated
Mar 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Authorized official

Name
Dr. Shahnaz Ali, M.D.NPI 1922020478
Title
Owner/Physician
Phone
(616) 808-2695

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301076867 MI Primary

Addresses

Primary practice location

1787 Grand Ridge CT NE
Ste 202
Grand Rapids, MI 49525-7042

Mailing address

PO Box 289
Jenison, MI 49429-0289
Phone (616) 457-9000

Other names 1

  • AGE MANAGEMENT & HORMONE BALANCE CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Age Management and Hormone Balance Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1598088171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494290289",
            "telephone_number": "616-457-9000",
            "fax_number": "616-457-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 GRAND RIDGE CT NE",
            "address_2": "STE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257042",
            "telephone_number": "616-808-2695",
            "fax_number": "616-808-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHNAZ ALI, M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "SHAHNAZ",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "616-808-2695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301076867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AGE MANAGEMENT & HORMONE BALANCE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.