Carol Prince, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

53005 Issued in WI

Practice address

1610 West Seven Mile Rd.
Detroit, MI 48203

Phone

(313) 595-3391

NPI assigned

Jul 5, 2007

Last updated

Mar 5, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, VI2 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

Specialty

Dermatology

Education

Michigan State University College of Human Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The St Thomas East End Medical Center CorporationGroup PAC ID 1153366398, 9 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The St Thomas East End Medical Center Corporation

  • Federal Public Health Clinic/Center
  • St Thomas, VI
  • NPI 1891799763
  Medicare reassignment Care Compare group NPD
• Heidelberg Dermatology, P.C.

  • Dermatology Physician
  • Detroit, MI
  • NPI 1124045075
  Medicare reassignment NPD

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1922206580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 WEST SEVEN MILE RD.",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48203",
            "telephone_number": "313-595-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 WEST SEVEN MILE RD.",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48203",
            "telephone_number": "313-595-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "262140",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "53005",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301038363",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primedical Healthcare Group PLLC
• Primedical Healthcare Group PLLC
• Primedical Urgent Care PLLC
• Trazell Primuse
• Angelisa Prince, LLMSW
• Chloe Prince I, LLBSW
• Donna Prince, M.D.
• Lakeisha Avery Prince, LLMSW
• Dennis E Pringle
• Spencer Printen

• Dermatology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.