Individual provider Active NPI

Gloria Egeh

  • Psychiatric/Mental Health Nurse Practitioner
  • Ypsilanti, MI
National Provider Identifier
1770219735
Registry record updated Sep 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704229640 Issued in MI
Practice address
7067 Poplar Dr
Ypsilanti, MI 48197-1768
Phone
(734) 218-2842
NPI assigned
Jul 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704229640 MI Primary

Addresses

Primary practice location

7067 Poplar Dr
Ypsilanti, MI 48197-1768

Mailing address

7067 Poplar Dr
Ypsilanti, MI 48197-1768
Phone (734) 218-2842

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221202001067 MI Practitioner - Nurse Practitioner 5496124083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

2350 Green Rd
Suite 150 160
Ann Arbor, MI 48105-1599
Phone (734) 285-8282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704229640MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Oct 31, 2022 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Oct 31, 2022 Accepting new patients

Locations

2350 Green Rd
Ste 160
Ann Arbor, MI 48105
Phone (315) 771-4657

2350 Green Rd
Ste 150160
Ann Arbor, MI 48105
Phone (734) 285-8282

2200 Genoa Business Park Dr
Ste 100
Brighton, MI 48114
Phone (810) 449-7180

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.gloriaegeh@150339.advancedmd-direct.com

Organizations & group practices 2

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": "1659139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1770219735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7067 POPLAR DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971768",
            "telephone_number": "734-218-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7067 POPLAR DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971768",
            "telephone_number": "734-218-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGEH",
        "first_name": "GLORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-30",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704229640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.