Individual provider Active NPI

Robert Kerry Shlain, DPM

  • Podiatrist
  • West Bloomfield, MI
National Provider Identifier
1861563512
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0927 Issued in MI
Practice address
7432 Sherwood Creek Court
West Bloomfield, MI 48322-3170
Phone
(248) 788-1099
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0927 MI Primary
Podiatrist 213E00000X E2537 CA
Podiatrist 213E00000X 1314 FL
Podiatrist 213E00000X 0748 TX

Addresses

Primary practice location

7432 Sherwood Creek Court
West Bloomfield, MI 48322-3170

Mailing address

7432 Sherwood Creek Court
West Bloomfield, MI 48322-3170
Phone (248) 788-1099

Other identifiers 1

IdentifierTypeStateIssuer
2114806MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111229000086 MI Practitioner - Podiatry 2961678792 Practice locations: West Bloomfield, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E2537CAMDPodiatrist
1314FLMDPodiatrist
0927MIMDPodiatrist
0748TXMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861563512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7432 SHERWOOD CREEK COURT",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223170",
            "telephone_number": "248-788-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7432 SHERWOOD CREEK COURT",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223170",
            "telephone_number": "248-788-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHLAIN",
        "first_name": "ROBERT",
        "middle_name": "KERRY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "0927",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2537",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "1314",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "0748",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2114806",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.