Individual provider Active NPI

Grace Eva Rotter

  • Student in an Organized Health Care Education/Training Program
  • Southfield, MI
National Provider Identifier
1992642318
Registry record updated May 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
21751 W 11 Mile Rd Ste 205
Southfield, MI 48076-3712
Phone
(248) 707-5409
NPI assigned
May 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI Primary

Addresses

Primary practice location

21751 W 11 Mile Rd Ste 205
Southfield, MI 48076-3712

Mailing address

30490 Stellamar St
Beverly Hills, MI 48025-4931

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1777680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777680000000",
    "number": "1992642318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30490 STELLAMAR ST",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480254931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21751 W 11 MILE RD STE 205",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763712",
            "telephone_number": "248-707-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTER",
        "first_name": "GRACE",
        "middle_name": "EVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-02",
        "last_updated": "2026-05-02",
        "certification_date": "2026-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2026; 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.