NPIMap

Organization Active NPI

University of Detroit Mercy

  • General Practice Physician
  • Detroit, MI
National Provider Identifier
1669187696
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
UNIVERSITY OF DETROIT MERCY
Practice address
4001 W McNichols Rd # Quad104
Detroit, MI 48221-3038
Phone
(313) 993-1185
NPI assigned
Jan 13, 2023
Last updated
Jan 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Deborah Stieffel, M.S.
Title
VP for Enrollment Management & Stud
Phone
(313) 993-1245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

4001 W McNichols Rd # Quad104
Detroit, MI 48221-3038

Mailing address

4001 W McNichols Rd # Quad104
Detroit, MI 48221-3038
Phone (313) 993-1185

Other names 1

  • University of Detroit Mercy Wellness Center Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://27227.portal.athenahealth.com/

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0985665University of Detroit Mercy Wellness Center4001 W McNichols Road, Detroit, MI 48221Certificate of waiverApr 5, 2028

National Provider Directory

National Provider Directory
Tax ID family
U of D Dental Schoo4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

4001 W McNichols Rd
Detroit, MI 48221
Phone (313) 993-1245

4001 W McNichols Rd
#104
Detroit, MI 48221
Phone (313) 993-1185

Practitioners & affiliated clinicians

Practitioners 71

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.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1669187696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 W MCNICHOLS RD # QUAD104",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213038",
            "telephone_number": "313-993-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W MCNICHOLS RD # QUAD104",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213038",
            "telephone_number": "313-993-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF DETROIT MERCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "STIEFFEL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VP FOR ENROLLMENT MANAGEMENT & STUD",
        "authorized_official_telephone_number": "313-993-1245",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://27227.portal.athenahealth.com/",
            "affiliation": "N",
            "endpointDescription": "Patient Portal Access Address",
            "address_1": "4001 W McNichols Rd # Quad104",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482213038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "University of Detroit Mercy Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.