Individual provider Active NPI

Ioana Stan, MD

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1962139964
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301514621 Issued in MI
Practice address
22250 Providence Dr Ste 557
Southfield, MI 48075-6213
Phone
(248) 849-3447
Fax
(248) 849-8021
NPI assigned
Aug 1, 2022
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301514621 MI Primary

Addresses

Primary practice location

22250 Providence Dr Ste 557
Southfield, MI 48075-6213

Mailing address

22250 Providence Dr Ste 557
Southfield, MI 48075-6213
Phone (248) 849-3447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220803002746 MI Order and Referring Only - Family PracticePractitioner - Family Practice 9537541859

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301514621MIMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ioana.stan.1@19270.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1962139964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 557",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756213",
            "telephone_number": "248-849-3447",
            "fax_number": "248-849-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 557",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756213",
            "telephone_number": "248-849-3447",
            "fax_number": "248-849-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAN",
        "first_name": "IOANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301514621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.