Anne Mare Ice

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

4301031683 Issued in MI

Practice address

23077 Greenfield Rd Ste 200
Southfield, MI 48075-3750

Phone

(313) 824-1000

NPI assigned

Jul 7, 2006

Last updated

May 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: aice@direct.dmc.org
• Direct secure messaging: anne.mare.ice.1@19827.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/19827/brand/1/csg/1/fhir/r4

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.

• Pediatric Staff PLLC

  • Specialist
  • Detroit, MI
  • NPI 1922140912
  Authorized official Same address or phone
• Detroit Wayne County Health Authority

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1245182963
  NPD (past)
• Detroit Wayne County Health Authority

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1962733089
  NPD (past)
• Partners in Wellness

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1518461524
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1902839764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22341 W 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482191217",
            "telephone_number": "313-255-2209",
            "fax_number": "313-255-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753750",
            "telephone_number": "313-824-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12121 Broadstreet Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482041550",
            "country_code": "US",
            "telephone_number": "313-824-1000 x2",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10809 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482142119",
            "country_code": "US",
            "telephone_number": "313-824-1000 x1",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27777 Lahser Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480344751",
            "country_code": "US",
            "telephone_number": "313-824-1000 x2",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22341 W 8 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482191217",
            "country_code": "US",
            "telephone_number": "313-255-2209 x234",
            "fax_number": "313-255-0773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICE",
        "first_name": "ANNE MARE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301031683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chidozie Obioma Ibeh
• Dina Faig Ibrahim, M.D.
• John Ibrahim, MSW
• Icare Medical Clinic PC
• Icare Wellness Group
• Icon Dental Implant Center
• Courage Osamudiamen Idahor
• Ideal Home Health Care, Inc
• Alyssa Ignasiak
• Zainab Ijaz, MD

• Pediatric Adolescent Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Pediatric Adolescent Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.