GORDON C WEATHERS (NPI# 1396268777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396268777 |
| Entity Type | Individual |
| Full Name | GORDON C WEATHERS |
| Practice Address |
1121 E Mcnichols Rd Detroit MI 48203-2857 |
| Mailing Address |
19639 W 12 Mile Rd Apt 201 Southfield MI 48076-2550 |
| Practice Telephone | 6163653100 |
| Practice Fax Number | 6163653100 |
| Mailing Telephone | 3134108851 |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| Street Address |
1121 E MCNICHOLS RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48203-2857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043302730 | John Lewis Eberhart | Counselor | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2006-09-29 |
| 1487266441 | Jeremiah Spears Jr. | Peer Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2020-08-20 |
| 1740892603 | Sheena Talanya Dalton | Peer Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2020-08-20 |
| 1467060368 | Diane Lassiter | Peer Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2020-07-16 |
| 1487262580 | Kenneth Mccoy | Peer Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2020-07-15 |
| 1780220632 | Mary Margaret Fleury | Peer Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2019-11-25 |
| 1992341846 | Roberta Wilson | Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2019-11-25 |
| 1255977104 | Debra Roberts | Peer Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2019-11-25 |
| 1952947806 | Dwayne Frank Muhammad | Peer Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2019-11-25 |
| 1821633371 | April Marie Doss | Counselor | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2019-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992355135 | James Calloway | Peer Specialist | 1211 E Mcnichols, Detroit, MI 48203 | 2019-09-19 |
| 1851868582 | Community Veterans Services Inc | Counselor | 163 Tennyson, Highland Park, MI 48203 | 2018-10-31 |
| 1346601838 | Rainbow Center of Michigan | Health Maintenance Organization | 12501 Hamilton Ave., Highland Park, MI 48203 | 2016-03-11 |
| 1134502354 | Minds Moving In New Directions Inc | Community/Behavioral Health | 62 Massachusetts St, Highland Park, MI 48203 | 2015-07-07 |
| 1811312937 | Brea Holloway | Home Health | 20249 Yacama Rd, Detroit, MI 48203 | 2014-02-26 |
| 1770821795 | St John Providence Health Systems | Community/Behavioral Health | 1150 Lantz St, Detroit, MI 48203 | 2013-01-25 |
| 1871845412 | Waneta Darcell Dickerson | Social Worker | 169 W. Buena Vista, Highlandpark, MI 48203 | 2012-10-05 |
| 1629331939 | Maureen Connolly | Pediatrics | 77 Victor St, Highland Park, MI 48203 | 2012-06-21 |
| 1578850251 | Detroit Recovery Project | Community/Behavioral Health | 1121 East Mc Nichols, Detroit, MI 48203 | 2011-07-01 |
| 1265728414 | Barbara Suzanne Tyson | Home Health | 301 Glendale St, Apt B8, Highland Park, MI 48203 | 2011-06-27 |
| Find all providers in zip 48203 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780229880 | Terri Dallas | Contractor | 59 Seward St Apt 603, Detroit, MI 48202-2431 | 2019-11-12 |
| 1033763347 | Latrese Tucker | Contractor | 9600 Wyoming, Detroit, MI 48204 | 2019-07-25 |
| 1154898146 | Israel Agodu | Contractor | 6474 Rosemont Ave, Detroit, MI 48228-4754 | 2018-10-27 |
| 1356894943 | Metecia Smith | Contractor | 11138 Findlay St, Detroit, MI 48205-4714 | 2016-07-29 |
| 1205286267 | Megan Boyle | Contractor | 17183 Griggs St, Detroit, MI 48221-2426 | 2016-06-20 |
| 1124486964 | Karen Porter | Contractor | 13994 Minock St, Detroit, MI 48223-2804 | 2016-02-08 |
| 1578936050 | Inglish Reed-jones | Contractor | 15 E Kirby St Ste B-7, Detroit, MI 48202-4047 | 2015-11-05 |
| 1811373269 | Venise Omeally | Contractor | 4757 Anthony Wayne Dr, Apt 2, Detroit, MI 48201-3750 | 2015-08-08 |
| 1124404553 | Wanda Marie Williams | Contractor | 4104 Woodhall St, Detroit, MI 48224-2221 | 2015-08-07 |
| 1316323942 | Vanessa Bryant | Contractor | 19691 Hasse St, Detroit, MI 48234-2155 | 2015-08-05 |
| Find all providers in DETROIT | ||||
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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.