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JOHN CHILDERS
NPI 1063036739
Student in an Organized Health Care Education/Training Program in Warren, MI

Active since May 29, 2020PECOS Enrolled
11885 E 12 MILE RD STE 300A, WARREN, MI 48093(586) 582-6630 Get Directions Write a Review

NPPES record last updated: May 29, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About John Childers NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN CHILDERS (NPI 1063036739) is an individual student in an organized health care education/training program in Warren, Michigan and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063036739
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJOHN CHILDERS
Location Address11885 E 12 MILE RD STE 300AWarren, MI 48093-3467
Mailing Address8390 Islandview CtBrighton, MI 48114-8789 · (810) 908-8757
Phone(586) 582-6630
Sole ProprietorNo
Enumeration DateMay 29, 2020
NPPES CertifiedMay 29, 2020
✔ NPI 1063036739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
11885 E 12 MILE RD STE 300A, Warren, MI 48093
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Childers is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL MARIE KOCH D.O.
Internal Medicine
11885 E 12 MILE RD STE 300A
WARREN, MI 48093
Macomb County (586) 582-6630
JON WHITMAN MACKEY D.O.
Internal Medicine
11885 E 12 MILE RD STE 300A
WARREN, MI 48093
Macomb County (586) 582-6630
PRACHI SHUKLA DO
Student in an Organized Health Care Education/Training Program
11885 E 12 MILE RD STE 300A
WARREN, MI 48093
Macomb County (586) 582-6630
THALHA AFRIDI DO
Student in an Organized Health Care Education/Training Program
11885 E 12 MILE RD STE 300A
WARREN, MI 48093
Macomb County (586) 582-6630
MISS CATHERINE JANE RAYMOND DO
Student in an Organized Health Care Education/Training Program
11885 E 12 MILE RD STE 300A
WARREN, MI 48093
Macomb County (586) 582-6630
JENNIFER MARIE RATHOUSKY D.O.
Internal Medicine
11885 E 12 MILE RD STE 300A
WARREN, MI 48093
Macomb County (586) 582-6630
DR. JUDY SHEFFEH MD
Student in an Organized Health Care Education/Training Program
11885 E 12 MILE RD STE 300A
WARREN, MI 48093
Macomb County (586) 582-6630
DR. KRISTINE ALEXIS NIXON DO
Internal Medicine
11885 E 12 MILE RD STE 300A
WARREN, MI 48093
Macomb County (586) 582-6630

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Childers's NPI number?

The NPI number for John Childers is 1063036739. It was assigned to this individual provider in the NPPES registry on May 29, 2020.

Where is John Childers located?

John Childers practices at 11885 E 12 Mile Rd Ste 300A, Warren, MI 48093. The listed phone number is (586) 582-6630.

What is John Childers's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is John Childers enrolled in Medicare?

Yes. John Childers is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for John Childers was last updated on May 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.