NPIMap

Organization Active NPI

Gateway Detroit

  • Preferred Provider Organization
  • Detroit, MI
National Provider Identifier
1831508522
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
6803086187 Issued in MI
Legal business name
GATEWAY DETROIT
Practice address
11457 Shoemaker St
Detroit, MI 48213-3418
Phone
(313) 331-3435
Fax
(313) 924-0609
NPI assigned
Aug 6, 2014
Organization subpart
Yes
Parent organization
GATEWAYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Authorized official

Name
Frederick Carr, B.S.,S.S.T
Title
Social Worker/Case Manager
Phone
(313) 331-3435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 6803086187 MI Primary

Addresses

Primary practice location

11457 Shoemaker St
Detroit, MI 48213-3418

Mailing address

11457 Shoemaker St
Detroit, MI 48213-3418
Phone (313) 331-3435

National Provider Directory

National Provider Directory
Tax ID family
Detroit East3 organizations share this tax ID, including this one
Part of
Detroit East

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1831508522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11457 SHOEMAKER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133418",
            "telephone_number": "313-331-3435",
            "fax_number": "313-924-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11457 SHOEMAKER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133418",
            "telephone_number": "313-331-3435",
            "fax_number": "313-924-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY DETROIT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "SOCIAL WORKER/CASE MANAGER",
        "authorized_official_telephone_number": "313-331-3435",
        "authorized_official_credential": "B.S.,S.S.T"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MI",
            "license": "6803086187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.