Organization Active NPI

Northwest Podiatry PC

  • Podiatrist
  • West Bloomfield, MI
National Provider Identifier
1821109836
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
NORTHWEST PODIATRY PC
Practice address
5755 W Maple Rd
Ste 115
West Bloomfield, MI 48322-4415
Phone
(248) 626-7180
Fax
(248) 626-7175
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Dr. Alan Schram, DPM
Title
Vice President
Phone
(248) 626-7180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

5755 W Maple Rd
Ste 115
West Bloomfield, MI 48322-4415

Mailing address

5755 W Maple Rd
Ste 115
West Bloomfield, MI 48322-4415
Phone (248) 626-7180

Other identifiers 4

IdentifierTypeStateIssuer
AS400226OtherMILICENSE
HR001598OtherMILICENSE
480F371150OtherMIBLUE CROSS BLUE SHIELD
LH000829OtherMILICENSE

National Provider Directory

National Provider Directory

Locations

5755 W Maple Rd
Ste 115
West Bloomfield, MI 48322
Phone (248) 626-7180

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1821109836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 W MAPLE RD",
            "address_2": "STE 115",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224415",
            "telephone_number": "248-626-7180",
            "fax_number": "248-626-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 W MAPLE RD",
            "address_2": "STE 115",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224415",
            "telephone_number": "248-626-7180",
            "fax_number": "248-626-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "SCHRAM",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "248-626-7180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AS400226",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "HR001598",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "480F371150",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LH000829",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.