Shauna Ryder Diggs MD PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301064244 Issued in MI

Legal business name

SHAUNA RYDER DIGGS MD PC

Practice address

17000 Kercheval Ave
Ste 215
Grosse Pointe Park, MI 48230-1570

Phone

(313) 822-5777

Fax

(313) 882-5776

NPI assigned

Aug 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shauna Ryder Diggs, MDNPI 1518027929

Title

President Owner

Phone

(313) 882-5777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shauna Ryder Diggs, M.D.,P.C.

  • Dermatology Physician
  • Grosse Pointe, MI
  • NPI 1518027929
  Medicare reassignment NPD Authorized official
• Kimberly Sarah Woolsey McDowell, DNP, MSN, FNP-BC, RN

  • Family Nurse Practitioner
  • Grosse Pointe, MI
  • NPI 1861107641
  NPD
• Lauren Plasky

  • Physician Assistant
  • Grosse Pointe, MI
  • NPI 1972379428
  NPD

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1871784702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36293",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482360293",
            "telephone_number": "313-822-5777",
            "fax_number": "313-882-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 KERCHEVAL AVE",
            "address_2": "STE 215",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301570",
            "telephone_number": "313-822-5777",
            "fax_number": "313-882-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAUNA RYDER DIGGS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "DIGGS",
        "authorized_official_first_name": "SHAUNA",
        "authorized_official_middle_name": "RYDER",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "313-882-5777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301064244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Grosse Pointe Park, MI
• Providers in Grosse Pointe Park, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.