Colleen Michelle Gwozdz, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008022 Issued in MI

Practice address

210 W Highland Rd
Suite 210
Highland, MI 48357-4573

Phone

(248) 887-5333

NPI assigned

Dec 2, 2016

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 2, 2016.

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1730622101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W HIGHLAND RD",
            "address_2": "SUITE 210",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574573",
            "telephone_number": "248-887-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W HIGHLAND RD",
            "address_2": "SUITE 210",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574573",
            "telephone_number": "248-887-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWOZDZ",
        "first_name": "COLLEEN",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Highland, MI
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.