NPIMap

Organization Active NPI

Comprehensive Clinical Neurology P.C.

  • Neurology Physician
  • Southfield, MI
National Provider Identifier
1891936977
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
DG050339 Issued in MI
Legal business name
COMPREHENSIVE CLINICAL NEUROLOGY P.C.
Practice address
28075 Ranchwood Dr
Southfield, MI 48076-2401
Phone
(248) 559-8737
Fax
(248) 559-7283
NPI assigned
Mar 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Dr. David Gaston, MDNPI 1811000227
Title
Dr
Phone
(248) 559-8737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X DG050339 MI Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

28075 Ranchwood Dr
Southfield, MI 48076-2401

Mailing address

28075 Ranchwood Dr
Southfield, MI 48076-2401
Phone (248) 559-8737

Other identifiers 1

IdentifierTypeStateIssuer
DP8335OtherMIRAILROAD MEDICARE

Other names 1

  • comprehensive clinical neurology PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100116000271 MI Part B Supplier - Clinic/Group Practice 3274675004 Receives reassigned benefits from 1 practitioner
Practice locations: Southfield, MI

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Clinical Neurology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17330 Northland Park Ct
Ste 205
Southfield, MI 48075
Phone (248) 809-2853

17330 Northland Park Ct
#205B
Southfield, MI 48075

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1891936977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28075 RANCHWOOD DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762401",
            "telephone_number": "248-559-8737",
            "fax_number": "248-559-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28075 RANCHWOOD DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762401",
            "telephone_number": "248-559-8737",
            "fax_number": "248-559-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE CLINICAL NEUROLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "GASTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "248-559-8737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "DG050339",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DP8335",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "comprehensive clinical neurology PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "comprehensive clinical neurology PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 May 11, 2023; 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.