NPIMap

Organization Active NPI

Botsford General Hosptial

  • Obstetrics & Gynecology Physician
  • Dearborn Heights, MI
National Provider Identifier
1710929468
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BOTSFORD GENERAL HOSPTIAL
Practice address
27031 W Warren St
Dearborn Heights, MI 48127-1901
Phone
(313) 561-1913
Fax
(313) 561-2196
NPI assigned
Jun 10, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Lee Ann Odom
Title
President Shared Services
Phone
(947) 522-3326

Corporate family (same tax ID) 19

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
ER Phys-Botsford Gen Ho (20 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

27031 W Warren St
Dearborn Heights, MI 48127-1901

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
OF37116OtherMIBLUE CROSS

Other names 1

NPPES NPI Registry
  • Comprehensive OBGYN - Dearborn Heights Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 18, 2021.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1710929468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27031 W WARREN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271901",
            "telephone_number": "313-561-1913",
            "fax_number": "313-561-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTSFORD GENERAL HOSPTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-3326"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "OF37116",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive OBGYN - Dearborn Heights",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Comprehensive OBGYN - Dearborn Heights",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.