| Covenant Community Care, Inc. | |
|
5716 Michigan Ave Detroit MI 48210-3039 | |
| (313) 554-1095 | |
| Not Available |
| Full Name | Covenant Community Care, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5716 Michigan Ave, Detroit, Michigan |
| Authorized Official Name and Position | Anna Griebel Chavez (CFO) |
| Authorized Official Contact | 3135540485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Community Care, Inc. 559 W Grand Blvd Detroit MI 48216-2200 Ph: (313) 554-1095 | Covenant Community Care, Inc. 5716 Michigan Ave Detroit MI 48210-3039 Ph: (313) 554-1095 |
| NPI Number | 1720134943 |
|---|---|
| Provider Enumeration Date | 01/28/2007 |
| Last Update Date | 04/10/2023 |
| Medicare PECOS PAC ID | 1254393549 |
|---|---|
| Medicare Enrollment ID | O20041029000105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720134943 | NPI | - | NPPES |
| Provider Name | Lisa J Mcintosh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205827573 PECOS PAC ID: 1557329992 Enrollment ID: I20041230000642 |
| Provider Name | Terry M Calcut |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467482745 PECOS PAC ID: 4587660618 Enrollment ID: I20061013000137 |
| Provider Name | Scott Paul Stryd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528032174 PECOS PAC ID: 8325105547 Enrollment ID: I20090316000117 |
| Provider Name | Sherwood D Pope |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245320118 PECOS PAC ID: 7618005943 Enrollment ID: I20100507000143 |
| Provider Name | Linda M Dillon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891919502 PECOS PAC ID: 2769507441 Enrollment ID: I20100917000920 |
| Provider Name | Mary K Hakim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518168020 PECOS PAC ID: 8921291212 Enrollment ID: I20101019000924 |
| Provider Name | Jeffrey D Ghioto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871715573 PECOS PAC ID: 4688728041 Enrollment ID: I20110707000641 |
| Provider Name | Kai K Palm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184853632 PECOS PAC ID: 3971757972 Enrollment ID: I20130128000487 |
| Provider Name | Michelle M Mcgarrity |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1841436375 PECOS PAC ID: 9739334723 Enrollment ID: I20130222000361 |
| Provider Name | Sage Mari Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518361336 PECOS PAC ID: 4486976107 Enrollment ID: I20141209001199 |
| Provider Name | R. Chase Stanley Thebault |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699920082 PECOS PAC ID: 8527114784 Enrollment ID: I20141218001086 |
| Provider Name | Kathryn Roehling |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1548546898 PECOS PAC ID: 3072805670 Enrollment ID: I20160629002581 |
| Provider Name | Lynn Eickholt |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1669636072 PECOS PAC ID: 7315237823 Enrollment ID: I20160701000154 |
| Provider Name | Liliana Chiesa-hilbrecht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831381391 PECOS PAC ID: 9133401193 Enrollment ID: I20170126002580 |
| Provider Name | Laura Pfeiffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285813824 PECOS PAC ID: 7911280557 Enrollment ID: I20170206002584 |
| Provider Name | Ioana Walter |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1467717215 PECOS PAC ID: 6406131374 Enrollment ID: I20170316001780 |
| Provider Name | Gloria Harrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285059501 PECOS PAC ID: 4688959190 Enrollment ID: I20170324000995 |
| Provider Name | Monica Elena Villa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083966097 PECOS PAC ID: 7113203548 Enrollment ID: I20170419000371 |
| Provider Name | David Gryniewicz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982019642 PECOS PAC ID: 2668771189 Enrollment ID: I20170511002418 |
| Provider Name | Megan Justine Fincher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174099188 PECOS PAC ID: 1658615422 Enrollment ID: I20181205000675 |
| Provider Name | Duston Boyd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538521331 PECOS PAC ID: 7719276963 Enrollment ID: I20191004001778 |
| Provider Name | Ryan Amber Beebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164071783 PECOS PAC ID: 8224461108 Enrollment ID: I20200805001320 |
| Provider Name | Rachel Claire Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720621279 PECOS PAC ID: 9638582687 Enrollment ID: I20210112000282 |
| Provider Name | Sajel Nuwamanya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558855387 PECOS PAC ID: 0840628376 Enrollment ID: I20210721001017 |
| Provider Name | Austin Christopher Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245894476 PECOS PAC ID: 1951712322 Enrollment ID: I20220803002039 |
| Provider Name | Aaron Nicol Neely |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255053419 PECOS PAC ID: 6204205453 Enrollment ID: I20221228002630 |
| Provider Name | Kimberly J Stafford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306011283 PECOS PAC ID: 1759732084 Enrollment ID: I20240110004338 |
| Provider Name | John Mark Ovies |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811325210 PECOS PAC ID: 7416307251 Enrollment ID: I20240112000241 |
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Chass Mack Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3426 Mack Avenue, Detroit, MI 48207 Phone: 313-849-3920 | |
Health Care Medical Center Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17141 Hayes St, Detroit, MI 48205 Phone: 313-245-1700 Fax: 313-245-1701 | |
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