NPIMap

Organization Active NPI

Common Ground Santuary

  • Nursing Care Agency
  • Pontiac, MI
National Provider Identifier
1972942423
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
4704150668 Issued in MI
Legal business name
COMMON GROUND SANTUARY
Practice address
461 W Huron St
Suite 100
Pontiac, MI 48341-1601
Phone
(248) 456-1991
NPI assigned
Jun 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Ms. Barbara Tanya-Jacknow Shreve, R.N,
Title
Staff Nurse
Phone
(248) 456-8150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 4704150668 MI Primary

Addresses

Primary practice location

461 W Huron St
Suite 100
Pontiac, MI 48341-1601

Mailing address

1410 S Telegraph Rd
Bloomfield Hills, MI 48302-0046
Phone (248) 456-8150

National Provider Directory

National Provider Directory
Tax ID family
Common Ground Santuary6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

461 W Huron St
Ste 100
Pontiac, MI 48341
Phone (248) 451-2608

Practitioners & affiliated clinicians

Practitioners 3

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": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1972942423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S TELEGRAPH RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020046",
            "telephone_number": "248-456-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 W HURON ST",
            "address_2": "SUITE 100",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-456-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMON GROUND SANTUARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "SHREVE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "TANYA-JACKNOW",
        "authorized_official_title_or_position": "STAFF NURSE",
        "authorized_official_telephone_number": "248-456-8150",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N,"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "MI",
            "license": "4704150668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.