Intraoperative Monitoring of Sem PLLC

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

INTRAOPERATIVE MONITORING OF SEM PLLC

Practice address

710 King Cir
Lake Orion, MI 48362-2782

Phone

(214) 269-3875

Fax

(903) 328-6568

NPI assigned

Nov 26, 2018

Last updated

Nov 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina Sullivan

Title

Billing Manager

Phone

(214) 269-3875

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543190400000",
    "number": "1740750439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43422 W OAKS DR # 430",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 KING CIR",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483622782",
            "telephone_number": "214-269-3875",
            "fax_number": "903-328-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRAOPERATIVE MONITORING OF SEM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "214-269-3875"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Rebekah Ikeler, RN
• Kelsey Marie Ikeler, RN
• Paul Ikonen, LMSW
• Independent Life Supportive Services
• Asha Cherie Ingalls
• Susan Irwin, OTR/L
• Frank James Iulianelli, D.C.
• J a Mastromatteo DDS PLLC
• Shermie Jacob
• Ashley Jacqmain

• Electrodiagnostic Medicine Physician in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Electrodiagnostic Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.