NPIMap

Organization Active NPI

Charlene Sharon Staff

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1619371564
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007192 Issued in MI
Legal business name
CHARLENE SHARON STAFF
Practice address
17701 Warwick St
Detroit, MI 48219-4210
Phone
(248) 971-9178
NPI assigned
Oct 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Authorized official

Name
Charlene Sharon Staff, P.A.
Title
Physician Assistant
Phone
(248) 971-9178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X 5601007192 MI Primary

Addresses

Primary practice location

17701 Warwick St
Detroit, MI 48219-4210

Mailing address

17701 Warwick St
Detroit, MI 48219-4210

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1619371564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17701 WARWICK ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17701 WARWICK ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194210",
            "telephone_number": "248-971-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLENE SHARON STAFF",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "STAFF",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "SHARON",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "248-971-9178",
        "authorized_official_credential": "P.A."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007192",
            "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 Oct 21, 2014; 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.