NPIMap

Organization Active NPI

Botsford General Hospital

  • Rheumatology Physician
  • Farmington Hills, MI
National Provider Identifier
1972545150
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
BOTSFORD GENERAL HOSPITAL
Practice address
28100 Grand River Ave
Suite 314
Farmington Hills, MI 48336-5967
Phone
(947) 521-1549
Fax
(248) 478-1827
NPI assigned
Jun 12, 2006
Organization subpart
Yes
Parent organization
BOTSFORD GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Authorized official

Name
Lesley Willbrandt
Title
Director Shared Services
Phone
(947) 522-1911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

28100 Grand River Ave
Suite 314
Farmington Hills, MI 48336-5967

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other identifiers 1

IdentifierTypeStateIssuer
110H299920OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Botsford Rheumatology Other name

National Provider Directory

National Provider Directory
Part of
ER Phys-Botsford Gen Ho

Locations

16186 Collection Center Dr
#D
Chicago, IL 60693

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1972545150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28100 GRAND RIVER AVE",
            "address_2": "SUITE 314",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365967",
            "telephone_number": "947-521-1549",
            "fax_number": "248-478-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTSFORD GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOTSFORD GENERAL HOSPITAL",
        "enumeration_date": "2006-06-12",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "WILLBRANDT",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "DIRECTOR SHARED SERVICES",
        "authorized_official_telephone_number": "947-522-1911"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "110H299920",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Botsford Rheumatology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Botsford Rheumatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.