Active NPI
Bryce R Cobb III
- Peer Specialist
- Romulus, MI
National Provider Identifier
1891339305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 34025 Pinewoods Cir Apt 103
Romulus, MI 48174-8219 - Phone
- (313) 477-6147
- NPI assigned
- Oct 29, 2019
- Last updated
- Oct 29, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
34025 Pinewoods Cir Apt 103
Romulus, MI 48174-8219
Mailing address
34025 Pinewoods Cir Apt 103
Romulus, MI 48174-8219
Phone (313) 477-6147
Other practice location 1
1121 E McNichols Rd
Detroit, MI 48203-2857
Phone (313) 365-3100
Other practice location 2
1145 W Grand Blvd
Detroit, MI 48208-2336
Phone (313) 324-8900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Detroit Recovery Project | Past | Accepting new patients | |
| The Detroit Recovery Project | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Detroit, MI
- NPI 1578850251
-
dba Detroit recovery Project, Inc
- Community/Behavioral Health Agency
- Detroit, MI
- NPI 1760890263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572307200000",
"number": "1891339305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34025 PINEWOODS CIR APT 103",
"city": "ROMULUS",
"state": "MI",
"postal_code": "481748219",
"telephone_number": "313-477-6147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34025 PINEWOODS CIR APT 103",
"city": "ROMULUS",
"state": "MI",
"postal_code": "481748219",
"telephone_number": "313-477-6147"
}
],
"practiceLocations": [
{
"address_1": "1121 E McNichols Rd",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482032857",
"country_code": "US",
"telephone_number": "313-365-3100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1145 W Grand Blvd",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482082336",
"country_code": "US",
"telephone_number": "313-324-8900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COBB",
"first_name": "BRYCE",
"middle_name": "R",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-29",
"last_updated": "2019-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Romulus, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.