NPIMap

Organization Active NPI

Detroit Medical Center

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
National Provider Identifier
1699327429
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Legal business name
DETROIT MEDICAL CENTER
Practice address
3901 Beaubien St
Detroit, MI 48201-2119
Phone
(313) 745-5147
NPI assigned
Jul 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Authorized official

Name
Sreedhar Reddy Mitta, MDNPI 1902455504
Title
Resident
Phone
(865) 771-5715

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2119

Mailing address

678 Selden St
Detroit, MI 48201-2200
Phone (865) 771-5715

Other identifiers 1

IdentifierTypeStateIssuer
4351045516OtherMIMEDICAL LICENSE NUMBER

Other names 1

  • Tenet Health Care Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smitta@dmc.org Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1699327429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 SELDEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012200",
            "telephone_number": "865-771-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "MITTA",
        "authorized_official_first_name": "SREEDHAR REDDY",
        "authorized_official_title_or_position": "RESIDENT",
        "authorized_official_telephone_number": "865-771-5715",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "4351045516",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smitta@dmc.org",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "3901 Beaubien St",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482012119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tenet Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 11, 2019; 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.