Active NPI
Gloria Rey, PAC
- Physician Assistant
- Detroit, MI
National Provider Identifier
1649335332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601004802
- Practice address
- 7733 E Jefferson Ave
Detroit, MI 48214-3707 - Phone
- (313) 499-4900
- NPI assigned
- Dec 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601004802 | MI | Primary |
Addresses
Primary practice location
7733 E Jefferson Ave
Detroit, MI 48214-3707
Mailing address
883 Reedmere
Windsor, ONTARIO N8S2L6
CA
Phone (215) 884-4503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601004802 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649335332",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "883 REEDMERE",
"city": "WINDSOR",
"state": "ONTARIO",
"postal_code": "N8S2L6",
"telephone_number": "215-884-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7733 E JEFFERSON AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482143707",
"telephone_number": "313-499-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REY",
"first_name": "GLORIA",
"credential": "PAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601004802",
"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 Jul 8, 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.