Brain Injury Diagnostic Centers

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

BRAIN INJURY DIAGNOSTIC CENTERS

Practice address

30400 Telegraph Rd Ste 133
Bingham Farms, MI 48025-4538

Phone

(313) 924-1447

Fax

(313) 488-0420

NPI assigned

Jun 1, 2021

Organization subpart

No

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

Authorized official

Name

Don Ballard

Title

Member

Phone

(713) 857-8292

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1942876867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30400 TELEGRAPH RD STE 133",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254538",
            "telephone_number": "313-924-1447",
            "fax_number": "313-488-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30400 TELEGRAPH RD STE 133",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254538",
            "telephone_number": "313-924-1447",
            "fax_number": "313-488-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN INJURY DIAGNOSTIC CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "713-857-8292"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacrista Sharmeail Bracey
• Asia Bradley
• Brian David Bradley
• Dana Maria Bradley
• Deloris Michelle Bradley
• Isabella Caterina Brandow
• Rachel Anita Brantley
• Katherine Brege-Biland, CRNA
• Elraya Tadiya Breham
• Annemarie Denise Brenner

• Medical Specialty Clinic/Center in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Medical Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.