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SAMARITAN BEHAVIORAL CENTER - PROFESSIONAL BILLING
NPI 1699234153
Nurse Practitioner in Detroit, MI

Active since March 14, 2019CLIA 23D1099230 · Waiver
5555 CONNER ST, DETROIT, MI 48213(313) 344-7730 Get Directions Write a Review

NPPES record last updated: May 29, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 29, 2019, Mar 14, 2019 (2 updates tracked since 2019).

About Samaritan Behavioral Center - Professional Billing NPPES

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

SAMARITAN BEHAVIORAL CENTER - PROFESSIONAL BILLING (NPI 1699234153) is a healthcare organization registered as a nurse practitioner in Detroit, Michigan and active in the NPI registry since March 2019. The organization holds a CLIA Waiver certificate valid through May 7, 2027 and lists Ryan Gunabalan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1699234153
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameMADISON COMMUNITY HOSPITAL INC
Location Address5555 CONNER STDetroit, MI 48213-3448
Mailing Address5555 Conner StDetroit, MI 48213-3448 · (313) 344-7730
Phone(313) 344-7730
Organization SubpartNo
Authorized OfficialRyan GunabalanCeo · (586) 261-2266
Enumeration DateMarch 14, 2019
Last NPPES UpdateMay 29, 20192 updates tracked since enumeration
✔ NPI 1699234153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
5555 CONNER ST, Detroit, MI 48213
Open in Google Maps ↗

Other Names 1

Doing Business AsSamaritan Behavioral Center - Professional Billing

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 23D1099230

Samaritan Behavioral Center · Detroit, MI
Active · expires May 7, 2027
CLIA Number23D1099230
Laboratory TypeHospital
Certificate Effective DateMay 8, 2025
Certificate Expiration DateMay 7, 2027
Laboratory DirectorLauren Iannotti
Laboratory Phone(313) 344-7730
Laboratory LocationSamaritan Behavioral Center5555 Conner Ave Suite 3 North, Detroit, MI 48213
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

SAMARITAN MI OPCO LLC
Skilled Nursing Facility
5555 CONNER ST
DETROIT, MI 48213
Wayne County (718) 838-1501
ADULT WELL-BEING SERVICES
Case Management
5555 CONNER ST, SUITE 1000 SOUTH DETROIT
DETROIT, MI 48213
Wayne County (313) 347-2070
HEALTHY PREFERRED INC
Clinical Medical Laboratory
5555 CONNER ST, SUITE 1100
DETROIT, MI 48213
Wayne County (313) 923-6566
KEVIN DUANE KROSBY AA
Counselor
5555 CONNER ST, SUITE 1000 SOUTH
DETROIT, MI 48213
Wayne County (313) 347-2070
MS. SANDRA M SCHIFF LMSW, PH.D.
Counselor (Mental Health)
5555 CONNER ST, STE. 1000 SOUTH
DETROIT, MI 48213
Wayne County (313) 347-2051
SONYA SHELMAN LLMSW
Social Worker
5555 CONNER ST
DETROIT, MI 48213
Wayne County (313) 308-0255
MARKIETA ARMSTRONG-LEWIS
Case Manager/Care Coordinator
5555 CONNER ST
DETROIT, MI 48213
Wayne County (313) 923-1655
MARY C PREDKO AT, ATC
Specialist/Technologist (Athletic Trainer)
5555 CONNER ST
DETROIT, MI 48213
Wayne County (313) 264-6490

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 Madison Community Hospital Inc's NPI number?

The NPI number for Madison Community Hospital Inc is 1699234153. It was assigned to this organization in the NPPES registry on March 14, 2019. The provider is doing business as Samaritan Behavioral Center - Professional Billing.

Where is Madison Community Hospital Inc located?

Madison Community Hospital Inc is located at 5555 Conner St, Detroit, MI 48213. The listed phone number is (313) 344-7730.

What is Madison Community Hospital Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Madison Community Hospital Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1099230) is associated with this NPI, valid through May 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Madison Community Hospital Inc was last updated on May 29, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.