Active NPI
Gouri Ramesh, M.D.
- Pediatric Adolescent Medicine Physician
- Detroit, MI
National Provider Identifier
1982634119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 4301064864
- Practice address
- 7900 Kercheval St
Detroit, MI 48214-2439 - Phone
- (313) 921-5500
- Fax
- (313) 921-5530
- NPI assigned
- Jul 4, 2006
- Last updated
- Jan 29, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 4301064864 | MI | Primary |
Addresses
Primary practice location
7900 Kercheval St
Detroit, MI 48214-2439
Mailing address
7900 Kercheval St
Detroit, MI 48214-2439
Phone (313) 921-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR064864 | Other | MI | BLUE CROSS BLUE SHIELD |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301064864 | MI | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Detroit Community Health Connection, Inc | Current | Accepting new patients | |
| Detroit Community Health Connection, Inc. | Current | Accepting new patients |
Locations
13901 E Jefferson Ave
Detroit, MI 48215
Phone (313) 821-2591
7900 Kercheval St
Detroit, MI 48214
Phone (313) 921-5500
Interoperability endpoints
- gouri.ramesh@dchc.directbygreenway.com
- gramesh@direct.dmc.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Detroit, MI
- NPI 1982611562
-
dba Dr. Peter Slaughter Health Center
- Federally Qualified Health Center (FQHC)
- Detroit, MI
- NPI 1588137376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1982634119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7900 KERCHEVAL ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482142439",
"telephone_number": "313-921-5500",
"fax_number": "313-921-5530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7900 KERCHEVAL ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482142439",
"telephone_number": "313-921-5500",
"fax_number": "313-921-5530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAMESH",
"first_name": "GOURI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MI",
"license": "4301064864",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "GR064864",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.