Individual provider Active NPI

Tammon Antoinette Nash, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
National Provider Identifier
1699864637
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301080091 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-8555
Fax
(313) 745-9299
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 4301080091 MI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301080091 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

1560 E Maple Rd
Suite 400- Credentialing Department
Troy, MI 48083-1138
Phone (313) 745-8555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080430000167 MI Practitioner - Pathology 7911086178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Wayne State University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

3990 John R St
Detroit, MI 48201-2018
Phone (313) 745-8040

Hospital & facility affiliations

  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301080091MIMDBlood Banking & Transfusion Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Anatomic Pathology & Clinical Pathology CurrentSince Jun 10, 2015 Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

1560 E Maple Rd
Ste 400
Troy, MI 48083

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: tnash@direct.dmc.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1699864637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400- CREDENTIALING DEPARTMENT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "313-745-8555",
            "fax_number": "313-745-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8555",
            "fax_number": "313-745-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "TAMMON",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "MI",
            "license": "4301080091",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301080091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.