CERTIFIED EMERGENCY MEDICINE SPECIALISTS, PC (NPI# 1104985001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104985001 |
| Entity Type | Organization |
| Organization Name | CERTIFIED EMERGENCY MEDICINE SPECIALISTS, PC |
| Practice Address |
5900 Byron Center Ave Sw Wyoming MI 49519 |
| Mailing Address |
Po Box 72011 Cleveland OH 44192-0002 |
| Practice Telephone | 6163637867 |
| Practice Fax Number | 6163639432 |
| Mailing Telephone | 6163637867 |
| Mailing Fax Number | 6163639432 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2017-03-14 |
| Authorized Official Name | MRS. SONYA D WILSON (PROVIDER CREDENTIALING) |
| Authorized Official Telephone | 6163637867 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | COMMUNITY HEALTH PLANS | 1002854 | 01 |
| MI | RAILROAD MEDICARE | 9300412441 | 01 |
| Street Address |
5900 BYRON CENTER AVE SW |
| City | WYOMING |
| State | MI |
| Zip Code | 49519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760484869 | Anita Irene Charochak | Internal Medicine | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2005-06-02 |
| 1912504283 | Jacalyn Kaiser | Occupational Therapist | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-10-08 |
| 1659987196 | David Paul Mandziara | Specialist/Technologist, Other | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9686 | 2020-09-21 |
| 1265048847 | Bella Baazov | Occupational Therapist | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-09-19 |
| 1548889504 | Maurice Anthony Marshall | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-10 |
| 1619596814 | Tyler Ledy | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9686 | 2020-04-09 |
| 1427677475 | James Darin Chessrown | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-09 |
| 1285263533 | Matthew Michael Gibbs | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-07 |
| 1427687755 | Molly Magen | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-07 |
| 1316576804 | Lindsay Grace Schichtel | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609364009 | Alexandra K Hylen | Dentist | 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 | 2018-05-01 |
| 1962925685 | Nicole Lee Kolasa | Rehabilitation Counselor | 2038 Melvin St. Sw, Wyoming, MI 49519 | 2017-07-25 |
| 1720534472 | Michael Ash | Rehabilitation Practitioner | 1870 36th Street, Wyoming, MI 49519 | 2016-08-31 |
| 1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
| 1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
| 1033547658 | Maranda Catherine Gary | Nurse Practitioner | 2122 Health Drive, Wyoming, MI 49519 | 2013-10-16 |
| 1144657800 | Diana Ro | Psychologist | 4211 Parkway Place Sw, #100, Wyoming, MI 49519 | 2013-09-26 |
| 1386077873 | Lindsey Elizabeth Chorney | Nurse Practitioner | 2122 Health Drive Sw, Suite 133, Wyoming, MI 49519 | 2013-08-20 |
| 1124377163 | Vision and Sensory Center of Michigan LLC | Optometrist | 4467 Byron Center Ave., Wyoming, MI 49519 | 2012-09-06 |
| 1881940203 | Judah | Durable Medical Equipment & Medical Supplies | 2975 Waterchase Way Sw Suite 307, Wyoming, MI 49519 | 2012-08-03 |
| Find all providers in zip 49519 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538689393 | Scott Howard | Emergency Medicine | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2017-06-22 |
| 1205147998 | Matthew L Carmichael | Emergency Medicine | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2010-06-28 |
| 1700844511 | Marc A Afman | Emergency Medicine | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2006-05-02 |
| 1528032539 | Todd Hartgerink | Emergency Medicine | 5900 Byron Center Ave Sw, Metro Health Hospital, Wyoming, MI 49519 | 2006-02-15 |
| 1578537478 | Eric Anderson | Emergency Medicine | 5900 Byron Center Ave, Wyoming, MI 49519 | 2006-02-15 |
| 1255304069 | Robert L Morris | Emergency Medicine | 5900 Byron Center Ave Sw, Metro Health Hospital, Wyoming, MI 49519 | 2006-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770059529 | Zachary Kenneth Brown | Emergency Medicine | 906 S Crapo St, Mt Pleasant, MI 48858-3662 | 2018-10-19 |
| 1356778286 | Donald Smith Pllc | Emergency Medicine | 1905 N Hammond Lake Dr, Bloomfield Hills, MI 48302-0139 | 2013-10-10 |
| 1346486222 | Flushing Road Urgent Care PC | Emergency Medicine | 1301 Flushing Rd, Flint, MI 48504-4710 | 2008-12-26 |
| 1184897209 | Donnell Stephen Newman Jr. | Emergency Medicine | 1460 Lakepointe St, Grosse Pointe Park, MI 48230-1016 | 2008-04-09 |
| 1205849866 | Daryl D Wisdom | Emergency Medicine | 10015 Cascade Rd Se, Lowell, MI 49331-9529 | 2006-08-14 |
| 1134131683 | Rick L Holland | Emergency Medicine | 8333 Felch Ave, Zeeland, MI 49464 | 2006-08-13 |
| 1760493472 | Katherine J Pitus | Emergency Medicine | 118000 E Twelve Mile Rd, Er Department, Warren, MI 48093 | 2006-08-10 |
| 1952319881 | Robert Prodinger | Emergency Medicine | 9825 W Gull Lake Dr, Richland, MI 49083-9543 | 2006-08-04 |
| 1164436671 | James Barry Nolin | Emergency Medicine | 1805 Wild Dr, Richland, MI 49083-9361 | 2006-07-28 |
| 1518987072 | Trace Dotson | Emergency Medicine | 118000 E Twelve Mile Road, Er Department, Warren, MI 48093 | 2006-07-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.