Active NPI
Denise Hillard Balon, MD
- Family Medicine Physician
- South Lyon, MI
National Provider Identifier
1861494965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301043800
- Practice address
- 210 N Lafayette St
South Lyon, MI 48178-2048 - Phone
- (248) 437-1744
- Fax
- (248) 437-3245
- NPI assigned
- Jun 2, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301043800 | MI | Primary |
Addresses
Primary practice location
210 N Lafayette St
South Lyon, MI 48178-2048
Mailing address
15990 West Nine Mile Road
Southfield, MI 48075-2527
Phone (248) 849-4226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410852110 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301043800 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298592000000",
"number": "1861494965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15990 WEST NINE MILE ROAD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752527",
"telephone_number": "248-849-4226",
"fax_number": "248-849-4240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N LAFAYETTE ST",
"city": "SOUTH LYON",
"state": "MI",
"postal_code": "481782048",
"telephone_number": "248-437-1744",
"fax_number": "248-437-3245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALON",
"first_name": "DENISE",
"middle_name": "HILLARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-02",
"last_updated": "2011-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301043800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "410852110",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Lyon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.