NPIMap

Organization Active NPI

Henry Ford Health Genesys Hospital

Doing business as Henry Ford Genesys Hospital

  • Clinical Psychologist
  • Burton, MI
National Provider Identifier
1932368537
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
HENRY FORD HEALTH GENESYS HOSPITAL
Doing business as
Henry Ford Genesys Hospital
Practice address
1460 N Center Rd
Burton, MI 48509-1429
Phone
(810) 715-4616
NPI assigned
Jun 9, 2008
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
Manager of Provider Affairs
Phone
(313) 874-6764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

1460 N Center Rd
Burton, MI 48509-1429

Mailing address

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

Other practice location 1

420 S Saginaw St
Flint, MI 48502-1803
Phone (810) 232-3522

Other identifiers 2

IdentifierTypeStateIssuer
OP250138OtherMIM CARE
680B512180OtherMIBS

Other names 1

  • Henry Ford Genesys Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000842 MI Part B Supplier - Clinic/Group Practice 2062323033 Receives reassigned benefits from 102 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Blanc, MI; Flint, MI; Burton, MI

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Benjamin Burroughs PA37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1932368537",
    "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": "1460 N CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091429",
            "telephone_number": "810-715-4616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 S Saginaw St",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485021803",
            "country_code": "US",
            "telephone_number": "810-232-3522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HENRY FORD HEALTH GENESYS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "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": "MANAGER OF PROVIDER AFFAIRS",
        "authorized_official_telephone_number": "313-874-6764"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M CARE",
            "identifier": "OP250138",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "680B512180",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Genesys Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burton, 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.