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PROVIDENCE HOSPITAL
NPI 1417196015
General Acute Care Hospital in Novi, MI

Active since February 05, 2009CLIA 23D2076351 · Waiver
47601 GRAND RIVER AVE, NOVI, MI 48374(248) 465-4249 Get Directions Write a Review

NPPES record last updated: February 5, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Providence Hospital NPPES

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

PROVIDENCE HOSPITAL (NPI 1417196015) is a healthcare organization registered as a general acute care hospital in Novi, Michigan and active in the NPI registry since February 2009. The organization holds a CLIA Waiver certificate valid through April 15, 2028 and lists Kathy A Klann, Supervisor, as its authorized official.

NPPES Registry Identity

NPI1417196015
Entity TypeOrganization
Primary Taxonomy282N00000X
Legal Business NamePROVIDENCE HOSPITAL
Location Address47601 GRAND RIVER AVENovi, MI 48374-1233
Mailing Address47601 Grand River AveNovi, MI 48374-1233
Phone(248) 465-4249
Organization SubpartNo
Authorized OfficialKathy A KlannSupervisor · (248) 465-4403
Enumeration DateFebruary 5, 2009
✔ NPI 1417196015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care HospitalHospitals
Taxonomy Code282N00000X
Definition
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.
47601 GRAND RIVER AVE, Novi, MI 48374
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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2076351

Providence Park Hospital · Novi, MI
Active · expires Apr 15, 2028
CLIA Number23D2076351
Laboratory TypeMobile Laboratory
Certificate Effective DateApril 16, 2026
Certificate Expiration DateApril 15, 2028
Laboratory DirectorJames M. Madison
Laboratory Phone(248) 921-0038
Laboratory LocationProvidence Park Hospital47601 Grand River Ave, Novi, MI 48374
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 23D1092252

Providence Park Hospital · Novi, MI
Expired · Aug 2, 2026
CLIA Number23D1092252
Laboratory TypeHospital
Certificate Effective DateAugust 3, 2024
Certificate Expiration DateAugust 2, 2026
Laboratory DirectorWaseem Farra
Laboratory Phone(248) 465-4745
Laboratory LocationProvidence Park Hospital47601 Grand River Ave, Novi, MI 48374
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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.

AFTAB AHMAD MD PC
Hospitalist
47601 GRAND RIVER AVE, C106
NOVI, MI 48374
Oakland County (248) 790-3087
JACOB KAINE YATES PTA
Physical Therapy Assistant
47601 GRAND RIVER AVE
NOVI, MI 48374
Oakland County (248) 465-4100
MUNE GOWDA MD
Surgery
47601 GRAND RIVER AVE, STE B129
NOVI, MI 48374
Oakland County (248) 305-8400
RAMYA GUTHIKONDA PT
Physical Therapist
47601 GRAND RIVER AVE
NOVI, MI 48374
Oakland County (248) 910-8834
SYDNEY KRENZ
Nurse Practitioner (Family)
47601 GRAND RIVER AVE
NOVI, MI 48374
Oakland County (248) 465-4100
MEDFIX P.C.
Clinic/Center (Primary Care)
47601 GRAND RIVER AVE, SUITE B-230
NOVI, MI 48374
Oakland County (248) 465-4444
HENRY FORD HEALTH PROVIDENCE HOSPITAL
General Acute Care Hospital
47601 GRAND RIVER AVE
NOVI, MI 48374
Oakland County (248) 465-4170
MARIE NALEZYTY MS, RD, CNSC
Dietitian, Registered
47601 GRAND RIVER AVE
NOVI, MI 48374
Oakland County (248) 880-3245

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 Providence Hospital's NPI number?

The NPI number for Providence Hospital is 1417196015. It was assigned to this organization in the NPPES registry on February 5, 2009.

Where is Providence Hospital located?

Providence Hospital is located at 47601 Grand River Ave, Novi, MI 48374. The listed phone number is (248) 465-4249.

What is Providence Hospital's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

Does Providence Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2076351) is associated with this NPI, valid through April 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Hospital was last updated on February 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.