NPIMap

Organization Active NPI

Providence Hospital

  • Chronic Disease Hospital
  • Southfield, MI
National Provider Identifier
1881891372
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chronic Disease HospitalTaxonomy code 281P00000X
Legal business name
PROVIDENCE HOSPITAL
Practice address
16400 N Park Dr Apt 1008
Southfield, MI 48075-4728
Phone
(248) 835-7259
NPI assigned
Jun 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gary G Otsuji, M.D.
Title
Programdirector
Phone
(248) 849-3447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chronic Disease Hospital 281P00000X Primary

Addresses

Primary practice location

16400 N Park Dr Apt 1008
Southfield, MI 48075-4728

Mailing address

16400 N.Park Drive Apt.1008
Southfield, MI 48075
Phone (248) 835-7259

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881891372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 N.PARK DRIVE APT.1008",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-835-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 N PARK DR APT 1008",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754728",
            "telephone_number": "248-835-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OTSUJI",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PROGRAMDIRECTOR",
        "authorized_official_telephone_number": "248-849-3447",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.