NPIMap

Organization Active NPI

Serenity Pediatrics

  • Pediatrics Physician
  • Bloomfield Hills, MI
National Provider Identifier
1669922977
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SERENITY PEDIATRICS
Practice address
71 E Long Lake Rd
Bloomfield Hills, MI 48304-9996
Phone
(248) 533-0000
Fax
(248) 785-3788
NPI assigned
Oct 11, 2016
Organization subpart
Yes
Parent organization
OPM DOCTORSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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

Authorized official

Name
Donna M Wilson
Title
Office Manager
Phone
(248) 533-0000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X MI Primary

Addresses

Primary practice location

71 E Long Lake Rd
Bloomfield Hills, MI 48304-9996

Mailing address

71 E Long Lake Rd
Bloomfield Hills, MI 48304-9996
Phone (248) 533-0000

Other names 1

  • Serenity Pediatrics Doing business as

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
23D2123321Serenity Pediatrics71 E Long Lake Road, Bloomfield Hills, MI 48304ComplianceNov 20, 2027

National Provider Directory

National Provider Directory
Part of
Serenity Pediatrics

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFFHAD

Practitioners & affiliated clinicians

Practitioners 11

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": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1669922977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 E LONG LAKE RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483049996",
            "telephone_number": "248-533-0000",
            "fax_number": "248-785-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 E LONG LAKE RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483049996",
            "telephone_number": "248-533-0000",
            "fax_number": "248-785-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PEDIATRICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPM DOCTORS",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-533-0000"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.