Henry Ford Shaped Beam Surgery, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

HENRY FORD SHAPED BEAM SURGERY, LLC

Practice address

2799 W Grand Blvd # M216
Detroit, MI 48202-2608

Phone

(313) 916-1078

Fax

(313) 916-3235

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Linda Wineski

Title

Manager

Phone

(313) 916-1078

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770635773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD. #M216",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-1078",
            "fax_number": "313-916-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD # M216",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1078",
            "fax_number": "313-916-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD SHAPED BEAM SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINESKI",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "313-916-1078"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H21883",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "514930",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henry Ford Hospital
• Henry Ford Hospital
• Henry Ford Medical Center
• Henry Ford Pathology
• Henry Ford Semi Medical Group
• Henry Ford Southeast Michigan Community Health
• Henry Ford Urgent Care
• Antonio Henry
• Chauntel Henry, RN
• Christine Eleanor Henry

• Radiology Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Radiology Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.