Individual provider Active NPI

Deven McCullers, MD

  • Pediatrics Physician
  • Ann Arbor, MI
National Provider Identifier
1710595129
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301511494 Issued in MI
Practice address
400 E Eisenhower Pkwy
Ann Arbor, MI 48108-3302
Phone
(734) 539-5080
NPI assigned
Jul 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 4301511494 MI Primary

Addresses

Primary practice location

400 E Eisenhower Pkwy
Ann Arbor, MI 48108-3302

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

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
I20241003002054 MI Practitioner - Pediatric Medicine 6800298548 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301511494MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Sep 10, 2024 Accepting new patients
Regents of the University of Michigan Pediatrics Current Accepting new patients
Regents of the University of Michigan Pediatrics CurrentSince Sep 10, 2024 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

400 E Eisenhower Pkwy
Ann Arbor, MI 48108
Phone (734) 232-2600

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

39901 Traditions Dr
Northville, MI 48168
Phone (248) 305-4400

Interoperability endpoints

  • Direct secure messaging: dmccullers115365@uihealth.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1710595129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E EISENHOWER PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083302",
            "telephone_number": "734-539-5080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLERS",
        "first_name": "DEVEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301511494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.