NPIMap

Organization Active NPI

Michigan Reproductive Medicine

  • Reproductive Endocrinology Physician
  • Bloomfield Hills, MI
National Provider Identifier
1801030218
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
MM0056302 Issued in MI
Legal business name
MICHIGAN REPRODUCTIVE MEDICINE
Practice address
41000 Woodward Ave
Suite 100 East
Bloomfield Hills, MI 48304-5130
Phone
(248) 593-6990
Fax
(248) 593-5925
NPI assigned
Apr 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Authorized official

Name
Mary Jo Mersol-Barg, MPA
Title
Manager
Phone
(248) 972-0877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VE0102X MM0056302 MI Primary

Addresses

Primary practice location

41000 Woodward Ave
Suite 100 East
Bloomfield Hills, MI 48304-5130

Mailing address

2830 Meadowood LN
Bloomfield, MI 48302-1029
Phone (248) 972-0877

Other identifiers 2

IdentifierTypeStateIssuer
14367AOtherMIHEALTH ALLIANCE PLAN
0633272OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN

Other names 1

  • Center for Reproductive Medicine and Surgery, PC Former legal business name

National Provider Directory

National Provider Directory

Locations

41000 Woodward Ave
Ste 100E
Bloomfield Hills, MI 48304

41000 Woodward Ave
Ste 100
Bloomfield Hills, MI 48304
Phone (248) 593-6990

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381190400000",
    "number": "1801030218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 MEADOWOOD LN",
            "city": "BLOOMFIELD",
            "state": "MI",
            "postal_code": "483021029",
            "telephone_number": "248-972-0877",
            "fax_number": "248-972-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41000 WOODWARD AVE",
            "address_2": "SUITE 100 EAST",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045130",
            "telephone_number": "248-593-6990",
            "fax_number": "248-593-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN REPRODUCTIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2013-10-08",
        "status": "A",
        "authorized_official_last_name": "MERSOL-BARG",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-972-0877",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MI",
            "license": "MM0056302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "14367A",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "0633272",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Reproductive Medicine and Surgery, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.