Individual provider Active NPI

Vanita Suzanni Robinson, ANP-BC

  • Primary Care Nurse Practitioner
  • Plymouth, MI
National Provider Identifier
1861806101
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704242745 Issued in MI
Practice address
15474 N Haggerty Rd
Plymouth, MI 48170-4893
Phone
(734) 335-6103
Fax
(734) 404-5317
NPI assigned
Jun 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704242745 MI Primary

Addresses

Primary practice location

15474 N Haggerty Rd
Plymouth, MI 48170-4893

Mailing address

1234 Meadowbrook St
1234 Meadowbrook
Detroit, MI 48214-3620
Phone (313) 821-0667

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140729000196 MI Practitioner - Nurse Practitioner 5799901781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Team Mental Health Services IncGroup PAC ID 2264451830, 33 clinicians

Practice addresses (Care Compare)

2925 Russell St
Detroit, MI 48207-4825
Phone (313) 396-5300

6309 Mack Ave
Detroit, MI 48207-2302
Phone (313) 921-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Team Wellness Center CurrentSince Aug 22, 2017 Accepting new patients
Common Ground CurrentSince Jun 20, 2024 Accepting new patients
Team Mental Health Services Inc. CurrentSince Aug 22, 2017 Accepting new patients

Locations

1410 S Telegraph Rd
Bloomfield Township, MI 48302
Phone (248) 451-3743

290 Town Center Dr
Ste 400
Dearborn, MI 48126
Phone (248) 763-5289

921 Howard St
Dearborn, MI 48124
Phone (313) 274-3700

6309 Mack Ave
Detroit, MI 48207
Phone (313) 331-3435

2925 Russell St
Detroit, MI 48207
Phone (313) 462-4714

1200 N Telegraph Rd
#32E
Pontiac, MI 48341
Phone (248) 451-2600

34290 Ford Rd
Westland, MI 48185
Phone (734) 412-8800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1861806101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 MEADOWBROOK ST",
            "address_2": "1234 MEADOWBROOK",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143620",
            "telephone_number": "313-821-0667",
            "fax_number": "313-821-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15474 N HAGGERTY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704893",
            "telephone_number": "734-335-6103",
            "fax_number": "734-404-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "VANITA",
        "middle_name": "SUZANNI",
        "credential": "ANP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-15",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704242745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.