Village of Grosse Pointe Shores

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE OF GROSSE POINTE SHORES

Practice address

795 Lake Shore Rd
Grosse Pointe Shores, MI 48236-1455

Phone

(313) 881-5500

Fax

(313) 640-1661

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Kenneth V Werenski

Title

Director of DPS

Phone

(313) 881-5501

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Grosse Pointe Shores DPS Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1871662791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 LAKE SHORE RD",
            "city": "GROSSE POINTE SHORES",
            "state": "MI",
            "postal_code": "482361455",
            "telephone_number": "313-881-5500",
            "fax_number": "313-640-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 LAKE SHORE RD",
            "city": "GROSSE POINTE SHORES",
            "state": "MI",
            "postal_code": "482361455",
            "telephone_number": "313-881-5500",
            "fax_number": "313-640-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF GROSSE POINTE SHORES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "WERENSKI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DIRECTOR OF DPS",
        "authorized_official_telephone_number": "313-881-5501"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MI",
            "license": "821012",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18-4258028",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grosse Pointe Shores DPS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Latiff
• Robert E Lee, MD
• Melanie Theofania Mermiges, PA-C
• Jennifer Suzanne Silverston
• Laura Smigielski, LPC

• Land Ambulance in Grosse Pointe Shores, MI
• Providers in Grosse Pointe Shores, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.