NPIMap

Organization Active NPI

University Internal Medicine Specialists

  • Gastroenterology Physician
  • Detroit, MI
National Provider Identifier
1609805969
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
UNIVERSITY INTERNAL MEDICINE SPECIALISTS
Practice address
4160 John R St
Suite 917
Detroit, MI 48201-2020
Phone
(313) 745-4525
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jill Moore
Title
Cao
Phone
(313) 745-8212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

4160 John R St
Suite 917
Detroit, MI 48201-2020

Mailing address

3800 Woodward Ave
Suite 702
Detroit, MI 48201-2061

National Provider Directory

National Provider Directory
Tax ID family
University Internal Medicine Specialists11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

4160 John R St
Ste 917
Detroit, MI 48201
Phone (313) 745-1445

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609805969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 702",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 917",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-745-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY INTERNAL MEDICINE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "313-745-8212"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.