NPIMap

Organization Active NPI

Transformation Medical Services, PC

  • Adult Medicine Physician
  • Southfield, MI
National Provider Identifier
1689942682
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
5101015861 Issued in MI
Legal business name
TRANSFORMATION MEDICAL SERVICES, PC
Practice address
21415 Civic Center Dr
Suite 111
Southfield, MI 48076-3909
Phone
(248) 356-1111
NPI assigned
Dec 5, 2011
Last updated
Dec 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Authorized official

Name
Dr. Addison Reede Tarr, D.O.
Title
President and Ceo
Phone
(714) 225-8665

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 5101015861 MI
Adult Medicine Physician 207QA0505X 5101015861 MI Primary

Addresses

Primary practice location

21415 Civic Center Dr
Suite 111
Southfield, MI 48076-3909

Mailing address

21415 Civic Center Dr
Suite 111
Southfield, MI 48076-3909
Phone (248) 356-1111

National Provider Directory

National Provider Directory

Locations

21415 Civic Center Dr
Ste 111
Southfield, MI 48076
Phone (248) 356-1111

Practitioners & affiliated clinicians

Practitioners 5

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": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1689942682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21415 CIVIC CENTER DR",
            "address_2": "SUITE 111",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763909",
            "telephone_number": "248-356-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21415 CIVIC CENTER DR",
            "address_2": "SUITE 111",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763909",
            "telephone_number": "248-356-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATION MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "TARR",
        "authorized_official_first_name": "ADDISON",
        "authorized_official_middle_name": "REEDE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "714-225-8665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "5101015861",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MI",
            "license": "5101015861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.