Individual provider Active NPI

Matthew Redigan, LLP

  • Addiction (Substance Use Disorder) Psychologist
  • Dearborn, MI
National Provider Identifier
1811098429
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
Practice address
5111 Auto Club Dr
112
Dearborn, MI 48126-2749
Phone
(313) 317-2000
Fax
(313) 317-2090
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X Primary

Addresses

Primary practice location

5111 Auto Club Dr
112
Dearborn, MI 48126-2749

Mailing address

5111 Auto Club Dr
112
Dearborn, MI 48126-2749
Phone (313) 317-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mredigan13182@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1811098429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR",
            "address_2": "112",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262749",
            "telephone_number": "313-317-2000",
            "fax_number": "313-317-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR",
            "address_2": "112",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262749",
            "telephone_number": "313-317-2000",
            "fax_number": "313-317-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDIGAN",
        "first_name": "MATTHEW",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mredigan13182@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.