Michigan Department of Corrections

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

2901014477 Issued in MI

Legal business name

MICHIGAN DEPARTMENT OF CORRECTIONS

Practice address

17600 Ryan Rd
Detroit, MI 48212-1155

Phone

(313) 368-3200

Fax

(313) 368-6015

NPI assigned

Oct 20, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jong Choi

Title

Regional Dental Director

Phone

(517) 780-5760

Specialties & licenses 2

Addresses

Locations

Practitioners 3

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

• Ronda Lyn Bryant, CNP

  • Acute Care Nurse Practitioner
  • Detroit, MI
  • NPI 1811202310
  NPD (past)
• Pamela Lynne Kuzera, FNP-C

  • Family Nurse Practitioner
  • Detroit, MI
  • NPI 1336646934
  NPD (past)
• Gail Eileen Wang, D.D.S

  • Dentist
  • Detroit, MI
  • NPI 1962875047
  NPD (past)

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1912379751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17600 RYAN RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121155",
            "telephone_number": "313-368-3200",
            "fax_number": "313-368-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 RYAN RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121155",
            "telephone_number": "313-368-3200",
            "fax_number": "313-368-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN DEPARTMENT OF CORRECTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-20",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "JONG",
        "authorized_official_title_or_position": "REGIONAL DENTAL DIRECTOR",
        "authorized_official_telephone_number": "517-780-5760",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MI",
            "license": "2901014477",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "2901014477",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Adult Empowerment Center, LLC
• Michigan Applied Behavior Analysis LLC
• Michigan Behavioral Wellness LLC
• Michigan Bone and Mineral Clinic, P.C.
• Michigan BS Opco LLC
• Michigan Emergency Services
• Michigan Emergency Services
• Michigan Emergency Services
• Michigan Employment & Training Plus
• Michigan Employment & Training Plus

• All providers in Detroit, MI
• Public Health or Welfare Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.