NPIMap

Organization Active NPI

Henry Ford Health Providence Hospital

Doing business as Henry Ford Providence Hospital

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1922063213
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Doing business as
Henry Ford Providence Hospital
Practice address
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone
(248) 849-3000
Fax
(248) 849-2244
NPI assigned
Apr 19, 2006
Last updated
Jul 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Authorized official

Name
Kimberly Cebalt
Title
Director
Phone
(313) 874-6764

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WD0400X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Nursing Care Agency 251J00000X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Mailing address

PO Box 670884
Detroit, MI 48267-0884
Phone (800) 999-5829

Other names 2

  • HENRY FORD PROVIDENCE HOSPITAL Doing business as
  • PH Internal Medicine/Providence Hospital and Medical Centers Inc Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000326 MI Part B Supplier - Clinic/Group Practice 6103738703 Receives reassigned benefits from 466 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

30055 Northwestern Hwy
#150160
Farmington Hills, MI 48334

32905 W 12 Mile Rd
Ste 150
Farmington Hills, MI 48334
Phone (248) 553-8360

26850 Providence Pkwy
Ste 505
Novi, MI 48374
Phone (248) 465-4163

15300 W 9 Mile Rd
Ste 1
Oak Park, MI 48237
Phone (248) 968-2003

22250 Providence Dr
Fl 5
Southfield, MI 48075
Phone (248) 849-3441

22250 Providence Dr
Ste 202
Southfield, MI 48075
Phone (248) 849-7400

22250 Providence Dr
Ste 301B
Southfield, MI 48075

22250 Providence Dr
Ste 706
Southfield, MI 48075
Phone (248) 424-5860

22255 Greenfield Rd
Ste 280
Southfield, MI 48075
Phone (248) 557-5227

Practitioners & affiliated clinicians

Practitioners 87

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.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1922063213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670884",
            "telephone_number": "800-999-5829",
            "fax_number": "248-641-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000",
            "fax_number": "248-849-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD HEALTH PROVIDENCE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "CEBALT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-874-6764"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENRY FORD PROVIDENCE HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PH Internal Medicine/Providence Hospital and Medical Centers Inc",
            "code": "5",
            "type": "Other 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 Jul 16, 2026; 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.