NPIMap

Organization Active NPI

Ccma-BT PLLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Dearborn, MI
National Provider Identifier
1730530973
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
CCMA-BT PLLC
Practice address
18181 Oakwood Blvd
Suite 208
Dearborn, MI 48124-5032
Phone
(313) 271-5565
Fax
(313) 271-1053
NPI assigned
Jun 29, 2016
Last updated
Apr 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Dr. Paul W Haydon, M.D.NPI 1609968577
Title
President
Phone
(313) 271-5565

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
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NU Primary

Addresses

Primary practice location

18181 Oakwood Blvd
Suite 208
Dearborn, MI 48124-5032

Mailing address

18181 Oakwood Blvd
Suite 208
Dearborn, MI 48124-5032
Phone (313) 271-5565

Other names 1

  • CCMABT Beaumont Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1730530973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "address_2": "SUITE 208",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245032",
            "telephone_number": "313-271-5565",
            "fax_number": "313-271-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "address_2": "SUITE 208",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245032",
            "telephone_number": "313-271-5565",
            "fax_number": "313-271-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCMA-BT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "HAYDON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-271-5565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCMABT Beaumont",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.