Pediatric Cardiology of Southeastren Michigan

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

Legal business name

PEDIATRIC CARDIOLOGY OF SOUTHEASTREN MICHIGAN

Practice address

1934 Bluff CT
Troy, MI 48098-6616

Phone

(248) 312-0005

Fax

(248) 940-2949

NPI assigned

May 21, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Regina C Shade

Title

Consultant

Phone

(586) 260-2858

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

Tax ID family

Pediatric Cardiology of Southeastren Mic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Cardiology of Southeastren Michigan, PLLC

  • Pediatric Cardiology Physician
  • Bloomfield Hills, MI
  • NPI 1386204022
  NPD tax ID

Locations

Practitioners 2

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

• Rossitza Prokopieva Pironkova, M.D.

  • Pediatric Cardiology Physician
  • Bloomfield Hills, MI
  • NPI 1316244304
  NPD
• Hanna Michel Khouri, M.D

  • Pediatric Cardiology Physician
  • Bloomfield Hills, MI
  • NPI 1770551301
  NPD (past)

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558396800000",
    "number": "1801453287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 BLUFF CT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986616",
            "telephone_number": "248-312-0005",
            "fax_number": "248-940-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 BLUFF CT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986616",
            "telephone_number": "248-312-0005",
            "fax_number": "248-940-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARDIOLOGY OF SOUTHEASTREN MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A",
        "authorized_official_last_name": "SHADE",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "586-260-2858",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770551301",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316244304",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pedcardsem@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1934 Bluff Ct",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480986616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pedcardsem@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1934 Bluff Ct",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480986616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Shanelle Nicole Pearse, DDS
• Charlotte Peck
• Pediatric Locum Care PLC
• Pediatric Urology of Mi
• Ann S Pekarek, APRN,BC
• Dawn Louise Pelino, OTR, CHT
• Amanda Marie Pelletier, NP

• Pediatric Cardiology Physician in Troy, MI
• Providers in Troy, MI by specialty
• Pediatric Cardiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.