NPIMap

Organization Active NPI

Botsford General Hospital

Doing business as Premier OBGYN

  • Obstetrics & Gynecology Physician
  • Farmington Hills, MI
National Provider Identifier
1609900828
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BOTSFORD GENERAL HOSPITAL
Doing business as
Premier OBGYN
Practice address
28100 Grand River Ave
Suite 306 South
Farmington Hills, MI 48336-5967
Phone
(947) 521-2649
NPI assigned
Mar 16, 2007
Last updated
Aug 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BOTSFORD GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Authorized official

Name
Lesley Willbrandt
Title
Director Shared Services
Phone
(947) 522-1911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

28100 Grand River Ave
Suite 306 South
Farmington Hills, MI 48336-5967

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other names 1

  • Premier OBGYN Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000592 MI Part B Supplier - Clinic/Group Practice 2668385238 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Novi, MI; Redford, MI; Livonia, MI; Farmington Hills, MI; Dearborn HTS, MI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Botsford General HSP20 organizations share this tax ID, including this one
Part of
Botsford General HSP

Other organizations with this tax ID 19

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

View all 19

Locations

28100 Grand River Ave
Ste 306
Farmington Hills, MI 48336
Phone (248) 476-1010

39475 Lewis Dr
Ste 270
Novi, MI 48377
Phone (248) 324-2161

Practitioners & affiliated clinicians

Practitioners 3

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1609900828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28100 GRAND RIVER AVE",
            "address_2": "SUITE 306 SOUTH",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365967",
            "telephone_number": "947-521-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTSFORD GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOTSFORD GENERAL HOSPITAL",
        "enumeration_date": "2007-03-16",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "WILLBRANDT",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "DIRECTOR SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-1911"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier OBGYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier OBGYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.