Active NPI
Liza Weathersby, MD
- Family Medicine Physician
- Redford, MI
National Provider Identifier
1780654806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301076032
- Practice address
- 15540 Beech Daly Rd
Redford, MI 48239-3804 - Phone
- (313) 387-5253
- Fax
- (313) 387-5263
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301076032 | MI | Primary |
Addresses
Primary practice location
15540 Beech Daly Rd
Redford, MI 48239-3804
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lweathersby96343@direct.beaumont.edu |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Wayne State University School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15540 Beech Daly Rd
Redford, MI 48239-3804
Phone (313) 387-5253
201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301076032 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakwood Ambulatory, LLC | Current | Accepting new patients | |
| Oakwood Ambulatory LLC | Family Medicine | Current | Accepting new patients |
| Hamilton Community Health Network Inc. | Past | Accepting new patients | |
| Botsford General Hospital | Past | Accepting new patients |
Locations
201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065
32754 Grand River Ave
Farmington Hls, MI 48336
Phone (248) 476-3280
15540 Beech Daly Rd
Redford, MI 48239
Phone (313) 387-5253
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
Interoperability endpoints
- lweathersby96343@direct.beaumont.edu
Organizations & group practices 4
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.
-
- Podiatrist
- Westland, MI
- NPI 1013157361
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- Federally Qualified Health Center (FQHC)
- Flint, MI
- NPI 1386624278
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1780654806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15540 BEECH DALY RD",
"city": "REDFORD",
"state": "MI",
"postal_code": "482393804",
"telephone_number": "313-387-5253",
"fax_number": "313-387-5263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEATHERSBY",
"first_name": "LIZA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-23",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301076032",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lweathersby96343@direct.beaumont.edu",
"affiliation": "N",
"address_1": "15540 Beech Daly Rd",
"city": "Redford",
"state": "MI",
"country_code": "US",
"postal_code": "482393804",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Redford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.