Active NPI
William James Vornberger, MD
- Family Medicine Physician
- Saint Clair Shores, MI
National Provider Identifier
1972552560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301074813
- Practice address
- 21099 Masonic Blvd
St Clair Shores, MI 48082-1045 - Phone
- (586) 226-6213
- Fax
- (586) 226-8180
- NPI assigned
- May 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301074813 | MI | Primary |
Addresses
Primary practice location
21099 Masonic Blvd
St Clair Shores, MI 48082-1045
Mailing address
21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone (586) 296-6213
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08-0501322-2 | Other | MI | BCBS PIN |
| 4471933 | Medicaid | MI | |
| 700E0117730 | Other | MI | BCBS GROUP NUMBER |
| CG4684 | Other | MI | RAILROAD GROUP PTAN |
| P00187766 | Other | MI | RAILROAD MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301074813 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1972552560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21099 MASONIC BLVD",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480821045",
"telephone_number": "586-296-6213",
"fax_number": "586-296-8180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21099 MASONIC BLVD",
"city": "ST CLAIR SHORES",
"state": "MI",
"postal_code": "480821045",
"telephone_number": "586-226-6213",
"fax_number": "586-226-8180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VORNBERGER",
"first_name": "WILLIAM",
"middle_name": "JAMES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301074813",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "08-0501322-2",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4471933",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP NUMBER",
"identifier": "700E0117730",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD GROUP PTAN",
"identifier": "CG4684",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P00187766",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.