Organization Active NPI

Ann E. Hern, M.D., P.C.

  • Dermatology Physician
  • Troy, MI
National Provider Identifier
1962689273
Registry record updated May 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
430152754 Issued in MI
Legal business name
ANN E. HERN, M.D., P.C.
Practice address
2221 Livernois Rd
Suite 101
Troy, MI 48083-1603
Phone
(248) 362-3500
Fax
(248) 362-1941
NPI assigned
Jan 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2009

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

Authorized official

Name
Dr. Ann E Hern, M.D.NPI 1316910649
Title
Owner/President
Phone
(248) 362-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 430152754 MI Primary

Addresses

Primary practice location

2221 Livernois Rd
Suite 101
Troy, MI 48083-1603

Mailing address

2221 Livernois Rd
Suite 101
Troy, MI 48083-1603
Phone (248) 362-3500

Other identifiers 2

IdentifierTypeStateIssuer
070F319160OtherMIBLUE CROSS BLUE SHIELD
1316910649OtherMIINDIVIDUAL NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090609000141 MI Part B Supplier - Clinic/Group Practice 1951451285 Receives reassigned benefits from 4 practitioners
Practice locations: Troy, MI

National Provider Directory

National Provider Directory

Locations

230 W Maple Rd
Ste 200
Troy, MI 48084
Phone (248) 362-3500

215 E Big Beaver Rd
Ste 200
Troy, MI 48083
Phone (248) 362-3500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1962689273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 LIVERNOIS RD",
            "address_2": "SUITE 101",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831603",
            "telephone_number": "248-362-3500",
            "fax_number": "248-362-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 LIVERNOIS RD",
            "address_2": "SUITE 101",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831603",
            "telephone_number": "248-362-3500",
            "fax_number": "248-362-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN E. HERN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "HERN",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "248-362-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MI",
            "license": "430152754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "070F319160",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1316910649",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.