Individual provider Active NPI

Christopher J Kliethermes, M.D.

  • Obstetrics & Gynecology Physician
  • Detroit, MI
National Provider Identifier
1912299058
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301119123 Issued in MI
Practice address
4201 Saint Antoine St Ste 4C
Detroit, MI 48201-2153
Phone
(313) 745-4525
Fax
(313) 745-4399
NPI assigned
May 9, 2011
Last updated
Jul 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Obstetrics & Gynecology Physician 207V00000X 2011014912 MO
Obstetrics & Gynecology Physician 207V00000X 4301119123 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St Ste 4C
Detroit, MI 48201-2153

Mailing address

6651 Main St Ste 1020
Dept. of OB/GYN
Houston, TX 77030-2351
Phone (832) 826-7371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150825003105 TX Practitioner - Obstetrics/Gynecology 4486960218 Reassigns benefits to 2 organizations
I20190814000712 MI Practitioner - Obstetrics/Gynecology 4486960218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2011014912MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jun 9, 2015 Accepting new patients
Baylor College of Medicine CurrentSince Jun 9, 2015 Accepting new patients
University Physician Group Obstetrics & Gynecology CurrentSince Jul 3, 2019 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Oct 28, 2017 Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4201 Saint Antoine St
Ste 4C
Detroit, MI 48201
Phone (313) 993-8645

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1912299058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 MAIN ST STE 1020",
            "address_2": "DEPT. OF OB/GYN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302351",
            "telephone_number": "832-826-7371",
            "fax_number": "832-826-7315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST STE 4C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4525",
            "fax_number": "313-745-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIETHERMES",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2011014912",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301119123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.