Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary 1st Priority Physical Therapy LLC Group 1134422363 Detroit 8/2/2016 MDHHS-OIG Suspension Summary A.N.N. Inc Home Health Agency 1598814501 Livonia 7/22/2015 MDHHS-OIG Suspension
A Dental Center PC - Allen Park Dental Group Allen Park 5/20/2004 HHS 1128(a)(1)
A Dental Center PC - Southgate Dental Group Southgate 7/20/2004 1128(a)(1) Acadian Diagnostic Laboratories LLC Laboratory 1316370950 Baton Rouge, LA 19D2062876 5/15/2021 MDHHS Terminated Summary Suspension Advanced Care Services Group 1811290794 Oak Park 12/22/2015 HHS 6/8/2018 MDHHS-OIG Terminated
MI-Licensing and Regulatory Voluntarily Advanced Homecare Pharmacy Pharmacy 1710923107 Redford 5301008284 10/14/2015 Affairs Surrendered Advanced Medical Services PLLC Summary dba Advanced Sleep Diagnostic Suspension of Michigan Group 1922451632 Lansing 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG Terminated Advanced Sleep Summary Neurodiagnostics PC Group 1134143654 Farmington Hills 10/15/2017 MDHHS-OIG Suspension Summary Suspension Alam, Waseem MD PC Medical Group 1184724114 Bloomfield Hills 7/29/2015 MDHHS-OIG 11/8/2018 MDHHS-OIG Terminated Summary Suspension Ali Elhorr M.D.P.C. Medical Group 1558651422 Dearborn 5/19/2015 DCH-OIG 11/1/2019 MDHHS-OIG Terminated
Volunatarily Surrendered - MI-Licensing Controlled and Substance Regulatory Facilty All American Pharmacy LLC Pharmacy 1609151109 Flint 2/14/2018 Affairs License Only Summary Suspension Allied Geriatric Services PC Medical Group 1821196551 Birmingham 3/6/2013 DCH 10/29/2018 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason American Home Doctors PC Medical Group 1740623222 Warren 8/21/2021 HHS Revokjed American Home Care Assistants Summary LLC Home Help Agency Detroit 8/17/2020 MDHHS-OIG Suspension
Summary American Medical Missionary Suspension Care Home Help Agency 1578600920 Saginaw 12/5/2016 MDHHS-OIG 1/9/2017 MDHHS-OIG Termination
MI-Licensing and Regulatory Andy's Motown Pharmacy Pharmacy 1053355271 Detroit 5301008407 3/28/2011 Affairs Suspended Angels Touch Home Health Care Summary LLC Home Health 1922252865 Taylor 3/6/2013 DCH Suspension Suspended At Home Doctors P.C. Group 1851627053 Lansing 5/23/2013 DCH-OIG DCH-OIG Terminated Summary AttarMD PC Group 1275720716 Livonia 9/19/2017 MDHHS-OIG Suspension Summary Suspension Awerbuch, Gavin MD PC Group 1003130352 Saginaw 6/19/2014 DCH-OIG 11/6/2018 MDHHS-OIG Terminated b3 Diagnostic Laboratory LLC Laboratory 1902287279 Troy 23D2097180 5/15/2021 MDHHS Terminated Summary Ban Mecheal MD PC Gruup 1033301569 Livonia 9/17/2019 MDHHS-OIG Suspension Summary Bay City Vascular P.C. Group 1346424009 Bay City 9/30/2015 MDHHS-OIG Suspension
Summary Suspension and Bennett Family Chiropractic PLLC Chiropractic Group 1386881191 Auburn Hills 5/27/2020 MDHHS-OIG Termination
Summary MI-Licensing Suspended and Volunatrily Regulatory 2/14/18 Surrendered Benstar Pharmacy LLC Pharmacy 1255679924 Detroit 5301010006 11/2/2017 Affairs 6/14/18 MDHHS-OIG Terminated Beval Medical Equipment & Supplies Supplier 1235163551 Royal Oak 562580933 06/11/2015 CMS Revoked Birmingham Rehab & Physical Rehab Therapy Therapy Center, Inc. Services Detroit 36687 12/18/2003 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Breakthrough Believers Recovery Summary and Healing Center Group 1376866160 Grand Rapids 3/31/2021 MDHHS-OIG Suspension BrightSmiles Dental Group 1508229014 West Bloomfield 20153421 1/26/2017 MDHHS Terminated BrightSmiles PA 161 Dental Group 1083848311 Waterfrd 20152161 1/26/2017 MDHHS Terminated
Broadstreet Nursing Center Nursing Facility 83418 9/27/2000
Summary Suspension Canton Urgent Care P.C. Group 1992830863 Canton 5/18/2016 MDHHS-OIG 1/18/2021 MDHHS-OIG Termination Controlled Substance C3- Facility MI-Licensing MI-Licensing license only and and summary Regulatory Regulatory suspended Carpenter Pharmacy Pharmacy 1578655627 Hamtramck 5315015095 6/14/2018 Affairs 10/10/2018 Affairs Suspended License Cedar Knoll Care Center Nursing Facility Grass Lake 3/7/2007 DCH Revocation Summary Center Light Home Help Care Home Help Agency Detroit 5/12/2020 MDHHS-OIG Suspension Summary Centrad Healthcare LLC Group 1346243979 Naperville, IL 11/14/2017 MDHHS-OIG Suspension Summary Suspension Christina L Kimbrough PLLC Group 1770933194 Southfield 5/1/2018 MDHHS-OIG 12/21/2018 MDHHS-OIG Terminated
Clinical Psychiatric Medicine PC Group 1386677185 Grandville 7/18/2013 DCH-OIG Suspended Summary Suspension Commerce Township Pharmacy Pharmacy 1851616452 Commerce Township 8/31/2011 DCH 5/30/2016 MDHHS-OIG Terminated Community Rehabiltation Summary Services Group 1669424776 Rose City 7/13/2016 MDHHS-OIG Suspension
Compassionate Doctors PC Group 1326153578 Southfield 7/30/2013 DCH-OIG 1128(a)(2) Complete Health, LLC Group Group 1083801500 Livonia 6/21/2011 HHS Summary Counseling Solutions Centers Group 1770021602 Troy 4/12/2021 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Voluntarily Creams N Caps Pharmacy 1386972859 Southfield 5301010570 10/14/2015 Affairs Surrendered
Cutting Edge Orthopaedics LLC Group 1295070746 Sylvania, OH 9/15/2015 MDHHS-OIG Suspended
Summary Suspension Davenport Pharmacy Pharmacy 1548585136 Saginaw 8/31/2011 DCH-OIG 5/23/2016 MDHHS-OIG Termination Dearborn Pharmacy, Inc. Pharmacy Dearborn 2/20/2006 HHS 1128(a)(3) Summary Dearborn Family Medicine Suspension Center Medical Group 1467407080 Dearborn 7/8/2013 DCH-OIG 5/5/2016 MDHHS-OIG Terminated Summary Suspension Dearborn Nuro Clinic PC Group 1568638088 Dearborn 12/1/2016 MDHHS-OIG 4/12/2018 MDHHS-OIG Terminated Summary Suspension Dearborn Podiatric Surgeons PC Group 1447467485 Dearborn 12/3/2017 MDHHS-OIG 12/26/2018 MDHHS-OIG Terminated
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Voluntary Dearborn Rx Pharmacy Group 1982054383 Dearborn 5301010958 7/26/2017 Affairs 12/13/2017 Affairs Termination Detroit Diverse Care, Inc. Physician Group Detroit 3/16/1997 HHS 1128(a)(1) Summary Detroit Medical Clinic Medical Group 1245244110 Detroit 7/30/2013 DCH-OIG 10/31/2019 MDHHS-OIG Suspension
Summary Suspension Diamond Pharmacy Pharmacy 1720380140 Kalamazoo NCPDP 2374724 8/19/2011 DCH 6/2/2016 MDHHS Termination
MI-Licensing Summary and SuspensionV Regulatory oluntarily Divine Pharmacy LLC Pharmacy 1003273202 Detroit 5301010794 4/13/2020 MDHHS-OIG 6/9/2021 Affairs Surrendered Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
Summary Downriver Medical Associates Suspension PLC Physician Group 1114055811 Monroe 3/21/2013 DCH 11/13/18 DCH Termination Dr Henderson Judy MD Family Summary Medicine PLLC Group 1841737277 Niles 6/1/2021 MDHHS-OIG Suspension Durand Clinic PC Physician Group Durand 9/20/2001 HHS 1128(a)(3) Summary Dwight E. Smith MD PC Physician Group 1003849753 Detroit 5/29/2012 DCH Suspension Summary Dynasty Health Solutions Inc Medical Group 1326586942 FErndale 8/4/2020 MDHHS-OIG Suspension Summary East Village Pharmacy Pharmacy 1982928818 Dearborn 8/29/2016 MDHHS-OIG Suspension
MI-Licensing License and Revocation Regulatory and Summary EB James Nursing Center Nursing Facility Detroit 83422 2/12/2002 Affairs Suspension Medical Supply Summary Elrington Medical Center PLLC Company 1205875697 Redford 10/22/2013 DCH-OIG Suspension
MI-Licensing and Regulatory 10/20/98: Elrose Health Services, Inc. SA Treatment Detroit 21431 4/17/1995 Affairs 10/20/1998 HHS 1128(a)(1)
MI-Licensing and Regulatory 10/20/98: Elrose Health Services, Inc. SA Treatment Detroit 21391 4/17/1995 Affairs 10/20/1998 HHS 1128(a)(1)
MI-Licensing and Regulatory 10/20/98: Elrose Health Services, Inc. SA Treatment Detroit 20731 4/17/1995 Affairs 10/20/1998 HHS 1128(a)(1) Enjoy Dental Care PC Dental Group Detroit 5/20/2004 HHS 1128(a)(1)
MI-Licensing and Regulatory Express Discount Pharmacy Pharmacy 1225537962 Detroit 5301011289 1/8/2021 Affairs Suspended Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Suspension EZ Sleep Supplies LLC Medical Supplier 1871640383 Okemos 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG Terminated
MI-Licensing and Regulatory Fleth Discount Pharmacy LLC Pharmacy 1245670447 Warren 5301010191 3/5/2018 Affairs Revoked Summary Four Leaf Clover Inc Medical Group 1750451357 Westland 7/29/2015 MDHHS-OIG Suspension Francis Street Medical Associaes Summary P.C. Medical Group 1730245499 Jackson 6/29/2016 MDHHS-OIG Suspension Summary Friendz Pharmacy Pharmacy 1396051629 Detroit 5301009394 6/27/2018 MDHHS-OIG Suspension
License Revocation and Summary Friendship Manor Nursing Home Nursing Facility Detroit 3/21/2006 DCH Suspension General Medicine PC Group 1811945199 Novi 6/28/2019 MDHHS Terminated Summary Georgetown Poidatric Surgeons Suspension PC Group 1508905985 Sterling Heights 12/3/2017 MDHHS-OIG 12/26/2018 MDHHS-OIG Terminated Summary Glen Saperstein LLC Medical Group 1184045296 Saginaw 3/15/2017 MDHHS-OIG Suspension Summary Global Health Pharmacy Pharmacy 1326342486 Pontiac 5301009521 6/27/2018 MDHHS-OIG Suspension Summary Gracee Pharmacy Okoh Isiah Pharmacy 129512124 Highland Park 5301011430 5/31/2021 MDHHS-OIG Suspension Summary Greater Detroit Physical Therapy Suspension & Rehabilitation PC Group 1205865318 Westland 7/29/2015 MDHHS-OIG 3/29/2019 MDHHS-OIG Terminated Summary Suspension Green Cross Medical Center P.C. Group 1427126655 Detroit 6/14/2016 MDHHS-OIG 8/31/2018 MDHHS-OIG Terminated Summary Happy Hearts Home Care Agency Home Help Agency Jackson 5/26/2020 MDHHS-OIG Suspension Suspended Suspended Harmony Interational Group 1487717666 Detroit 1/16/2013 DCH-OIG 1/16/2013 DCH Terminated Harmony Turning Point PLLC Group 1588979686 Southfield 10/20/2013 HHS Excluded Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Suspension Harper Dermatology PC Group 1598032070 Roseville 3/5/2018 MDHHS-OIG 11/1/2019 MDHHS-OIG Terminated Summary Suspension Hartford Chiropractic Clinic Group 1699882951 Hartford 6/6/2017 MDHHS-OIG 9/23/2017 MDHHS-OIG Terminated Summary Hatem Ataya M.D. PC Group 1528295375 Davison 6/18/2015 DCH-OIG Suspension Summary Healing Hands Chiropractic Clinic Suspension LLC Group 1871779025 Coldwater 4/29/2015 DCH-OIG 9/26/2018 MDHHS-OIG Terminated Summary Suspension Highland Park Pharmacy Pharmacy 1104097781 Warren 8/31/2011 DCH-OIG 5/25/2016 MDHHS-OIG Terminated
Hi-Tech Home Health Care INC. Home Health Agency 1669702593 Farmington Hills 7/28/2016 HHS Terminated Home Clinic P.C. Group 1962645689 Southfield 12/29/2015 MDHHS-OIG Temination
Summary Suspension 3/6/2013 DCH Termination Home Physician Services PC Group 1346347523 Troy 3/6/2013 DCH-OIG 08/09/2016 MDHHS-OIG Termination Summary Suspension Homecare Doctors LLC Group 1487723771 Detroit 7/30/2013 DCH-OIG 10/29/2018 MDHHS-OIG Terminated Summary Suspension House Calls Physicians PLLC Group 1033273008 Allen Park 5/21/2013 DCH-OIG 5/5/2016 MDHHS-OIG Terminated Hugs of Love Home Health Care Summary LLC Home Health Agency Eastpointe 5/27/2020 MDHHS-OIG Suspension Summary Suspension Independent Care Pharmacy LLC Pharmacy 1619131141 Dearborn 8/11/2011 DCH-OIG 5/23/2016 MDHHS-OIG Terminated Ambulatory Surgical Summary Interventional Pain Center PLLC Center 1013385046 Warren 12/26/2018 MDHHS-OIG Suspension
Summary Jefferson Medical Industrial Clinic Suspension P.C. Group 1407178627 Detroit 7/4/2016 MDHHS-OIG 1/9/2017 MDHHS-OIG Ternminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Voluntarily Joe's Discount Pharmacy Pharmacy 1770953234 Detroit 5301010738 6/13/2018 Affairs Surrendered Suspended John R. Verbovsky D.O. P.C. Dental Group 1508153909 Sterling Heights 3/10/2015 MDHHS-OIG 12/14/2015 MDHHS-OIG Terminated Summary Suspension Jones Psychological Services PLLC Medical Group 1295092310 Port Huron 5/9/2018 MDHHS-OIG 6/8/2018 MDHHS-OIG Terminated Summary Josephson Nursing Home Nursing Facility 1700891504 Ironwood 1070000191 4/18/2012 DCH Suspension Summary Julia McGowen- Bienkowski LLC Group 1750902912 Clinton Township 4/20/2021 MDHHS-OIG Suspension Kalamazoo Footcare Specialists PC Podiatry Group Kalamazoo 4/10/2007 HHS 1128(b)(1) Suspended Kentwood Pharmacy Pharmacy 1346419892 Grand Rapids 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIG Terminated Suspended Kentwood Pharmacy Pharmacy 1558478610 Grand Rapids 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIG Terminated Suspended Kentwood Pharmacy Pharmacy 1841446192 Shepherd 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIG Terminated Suspended Kentwood Pharmacy Pharmacy 1548426992 Alma 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIG Terminated Suspended Kentwood Pharmacy Pharmacy 1760638019 Saint Louis 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIG Terminated Kirk Anthony DPM PC Group 1578872438 Grand Rapids 7/18/2013 DCH-OIG Suspended Summarily Suspended Krish Pharmacy Inc Pharmacy 1871698266 Chesterfield 7/30/2013 DCH-OIG 5/18/2016 MDHHS- OIG Terminated
MI-Licensing and Regulatory License L & L Nursing Center, Inc. Nursing Facility Detroit 83430 10/8/1998 Affairs Revocation Lake MI Doctors Housecalls (D/B/A Lake MI Mobile Doctors, Summary P.C) Group 1700950607 Southfield 12/3/2013 DCH-OIG Suspended
Lakeshore Diagnostic Ultrasound Group 1598746919 Essexville 11/8/2019 HHS-OIG Excluded Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason License MI-Licensing Revocation and and Regulatory decertificatio LaSalle Nursing Home Nursing Facility Detroit 83453 11/14/2003 Affairs n Summary Liberty Express Care Group 1508066036 Saginaw 12/5/2016 MDHHS-OIG 2/9/2017 Suspension Summary Life Care Sleep & Health Center Suspension LLC Group 1477584688 Lansing 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG Terminated Decertificatio Litchfield Nursing Centre Nursing Facility Litchfield 5/4/2007 HHS n LiteMed Rx Inc Pharmacy 1457774366 Garden City 5301010314 2/4/2017 HHS Revoked Little Traverse Bay Family Medicine Group 1417136425 Petosky 3/16/2015 DCH-OIG Terminated
Summary Suspension Livernois Family Medical Service Group 1417985441 Livernois 4/6/2015 DCH-OIG 6/2/2016 MDHHS-OIG Termination Livernois Family Pharmacy Pharmacy 1790866416 Detroit 5301007422 8/26/2014 DCH-OIG Suspended Summary Livestrong Pharmacy Pharmacy 1275925950 Detroit 12/25/2017 MDHHS-OIG Suspension Summary Livonia Care Pharmacy Pharmacy 1942560529 Port Huron 5301009802 1/25/2018 MDHHS-OIG Suspension
MI-Licensing and Regulatory Voluntarily Madison Pharmacy Inc Pharmacy 1790961118 Madison Heights 5301009979 8/9/2017 Affairs Surrendered Mancewicz & White DDS, PC Dental Group Grand Rapids 6/20/2002 HHS 1128(a)(1) Summary Suspension Medaplex Dental Center Dental Group 1326343542 Oak Park 1/18/2017 MDHHS-OIG 6/15/2018 MDHHS-OIG Terminated Metric Lab Services LLC Laboratory 1699287300 Ridgeland, MS 5/15/2021 MDHHS Terminated
Summary Suspension Metro Mobile Physicians Group 1962704239 Ferndale 7/13/2016 MDHHS-OIG 9/30/2019 MDHHS-OIG Termination Summary Michigan Brain and Spine Suspension Ohysicians Group, PLLC Group 1760771117 Southfield 3/10/2015 DCH-OIG 4/26/2017 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Suspension Michigan Diagnostic Services Inc. Group 1497923858 Bloomfield Hills 10/8/2018 MDHHS-OIG 11/7/2018 MDHHS-OIG Terminated Suspended Midwest Family Diagnostics PLC Group 1184952053 Warren 7/3/2013 DCH-OIG 5/5/2016 MDHHS-OIG Terminated Summary Suspension Midwest Family Practice PLC Group 1770819864 Warren 7/3/2013 DCH-OIG 5/5/2016 MDHHS-OIG Terminated Summary Midwest Prostate & Urological Suspension Institute Group 1508834755 Saginaw 2/13/2017 MDHHS-OIG 8/31/2018 MDHHS-OIG Terminated Summary Millner, Joel A MD PC Medical Group 1265715700 Ferndale 6/20/2014 DCH-OIG Suspension Summary Monroe Geriatric Evaluation and Suspension Management Services PLLC Group 1215117023 Monroe 3/21/2013 DCH-OIG 11/13/2018 MDHHS-OIG Terminated
Summary Suspension/T Monroe Medical Clinic PLLC Group 1972699312 Durand 9/18/2013 DCH-OIG ermination Moss, David M., DPM, PC Group Garden City 8/20/2003 HHS 1128(a)(1)
Summary Suspension Mykal Discount Pharmacy Pharmacy 1043549223 Detroit 5301009264 3/18/2011 DCH 7/11/2016 MDHHS-OIG Termination
Summary Suspension MyKal Discount Pharmacy #2 Pharmacy 1780992750 Pontiac 5301009423 3/18/2011 DCH 7/11/2016 MDHHS-OIG Termination
Summary Suspension/ My Visiting Physicians PC Group 1740512201 Southfield 1/16/2013 DCH-OIG Termination Summary Nat Lab Laboratory 1861934168 Detroit 12/25/2017 MDHHS-OIG Suspension Summary National Laboratories Inc Laboratory 1144645235 Detroit 12/25/2017 MDHHS-OIG Suspension Summary New Center Medical PC Group 1316482870 Detroit 12/18/2017 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
New Era Alternative Treatment Center, Inc. (NEAT) SA Treatment Flint 50219 9/20/2001 HHS
New Era Alternative Treatment Center, Inc. (NEAT) SA Treatment Highland Park 21310 9/20/2001 HHS Summary Suspension Northside Medical Clinic PC Group 1841357464 Cheboygan 4/4/2016 MDHHS-OIG 1/10/2019 MDHHS-OIG Terminated Northwest Industrial & Medical Services PC Group 1346364619 Detroit 7/3/2013 DCH-OIG Suspended Nottingham Pharmacy Pharmacy 1730209743 Detroit 5301005956 8/5/2020 MDHHS-OIG Suspended
MI-Licensing and Regulatory Omega Pharmacy Pharmacy 1508299710 Pontiac 5301010143 2/21/2016 Affairs Suspended Summary Suspension One on One Care LLC Group 1871997775 Warren 10/15/2017 MDHHS-OIG 10/31/2019 MDHHS -OIG Terminated
Suspended/d ebarred from OURLAB Laboratory 1760461909 Nashville, TN 11/25/2013 State of TN state of TN Summary Suspension Oval Dental Dental Group 1215476387 Westland 12/19/2018 MDHHS-OIG 8/7/2020 MDHHS Terminated Summary Park Dental of Okemos P.C. Dental Group 1477890689 Okemos 7/6/2016 MDHHS-OIG Suspension Park Medical Clinic PC Medical Group Troy 7/29/1997 HHS 1128(a)(1)
Summary Suspension Patient Choice Internal Medicine Group 1396094926 Detroit 7/13/2016 MDHHS-OIG 9/30/2019 MDHHS-OIG Termination
MI-Licensing Summary and Suspension Regulatory Summary People Pharmacy LLC Pharmacy 1720121668 Detroit 5301008586 11/20/2018 Affairs 6/11/2019 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Voluntarily Peoples Pharmacy Corp Pharmacy 1255655130 Detroit 5315044450 10/14/2015 Affairs Surrendered Summary Personal Angels Advocates LLC Home Help Agency Eastpointe 5/27/2020 MDHHS-OIG Suspension Summary Phoenix Visiting Physicians PLLC Group 1235458217 Livonia 5/29/2012 DCH-OIG Suspension Summary Pickens, Alex M.D.P.C. Group 1952529091 Detroit 8/23/2017 MDHHS-OIG Suspension Summary Pondview Personal Physician PC Group 1245430230 Madison Heights 11/14/2017 MDHHS-OIG Suspension Summary Precare Pharmacy Pharmacy 1346686854 Redford 5301010095 6/27/2018 MDHHS-OIG Suspension
Preferred Home Health Care Inc Home Health Agency 1801871496 Mount Clemens 237457 7/30/2013 DCH-OIG Suspended Summary Suspension Preferred Pharmacy Pharmacy 1669616785 Troy 8/30/2011 DCH-OIG 5/25/2016 MDHHS-OIG Terminated
Summary Suspension Preferred Pharmacy Pharmacy 1922322007 Troy 8/30/2011 DCH 5/25/2016 MDHHS-OIG Termination Suspended Premier Medical Center PLLC Group 1659631265 Warren 7/3/2013 DCH-OIG 5/5/2016 MDHHS-OIG Terminated Summary Professional Consultants, Inc Group 1063578045 Bloomington Hills 3/25/2015 DCH-OIG Suspension Summary Professional Consultants, Inc Group 1063578045 Bloomfield Hills 3/11/2015 DCH-OIG Suspension
Provider Service Organization Group 1447610704 Canton 5/8/2021 MDHHS Terminated Qandil Family Medical and Summary Urgent Care PLLC Medical Group 1013149616 Hamtramck 1/15/2013 DCH-OIG Suspension
MI-Licensing and Regulatory Summary Riverside Professional Drugs Inc. Pharmacy 1720196181 Trenton 5/15/2013 Affairs Suspension Summary Rizwan Qadir MD PC Medical Group 1003095043 Detroit 7/29/2015 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Rockafellow Psychological Suspension Services Group 1538444930 Oxford 7/6/2016 MDHHS-OIG 1/10/2019 MDHHS-OIG Terminated Summary Suspension Roth, Michael A MD PC Group 1831190917 Farmington Hills 8/9/2016 MDHHS-OIG 8/31/2018 MDHHS-OIG Terminated
MI-Licensing License and revocation Regulatory and summary Rosewood Living Center Nursing Facility Detroit 83447 8/14/2003 Affairs suspension Saab Drugs, Inc. Pharmacy 1538260633 Livonia 5301007790 6/18/2009 HHS 1128(a)(4) Pharmacy/Medical Saab Drugs, Inc. Supplier 1538260633 Farmington Hills 5301007790 6/18/2009 HHS 1128(a)(4) Sav-Max Pharmacy Pharmacy 1750346557 Detroit 7/30/2013 DCH-OIG Suspended
MI-Licensing and Regulatory Voluntarily Serv-U-Well Pharmacy Pharmacy 1275544785 Detroit 8/11/2015 Affairs Surrendered Summary Suspension Shelby Dental Center PC Dental Group 1154626687 Shelby Township 1/18/2017 MDHHS-OIG 6/15/2018 MDHHS-OIG Terminated Suspended SKA at Home Visting Doctor PC Group 1043507379 Albion 7/3/2013 DCH-OIG 0/12/2016 MDHHS-OIG Terminated Summary Suspension Sleep Diagnostics of Michigan PC Group 1407827900 West Branch 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG Terminated Soliman Medical Center PLLC Group 1952503559 Wayne 7/3/2013 DCH-OIG Suspended Soliman Medical Center PLLC Group 1619946043 Wayne 7/3/2013 DCH-OIG Suspended Somewere to Go Something to Do Adult Day Care LLC Group 1467853754 Lathrup Village 6/28/2019 MDHHS Terminated
MI-Licensing and Regulatory Voluntarily Southwest Discounty Pharmacy Pharmacy 1578690186 Detroit 5301008142 6/13/2018 Affairs Surrendered
Southwest Visiting Physicians Group 1881868685 Warren 12/29/2015 MDHHS-OIG Terminated
Spectrum Diagnostice Lab LLC Laboratory 1497173348 Arlinton, TX 45D2081429 5/8/2021 MDHHS Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Sunrise Pharmacy Pharmacy 1457996662 Detroit 5301012190 8/5/2020 MDHHS-OIG Suspended
MI-Licensing and Regulatory Summary Super Mart Pharmacy Pharmacy 1124322128 Detroit 5301009405 3/14/2018 Affairs Suspension Synergy Pharmacy Pharmacy 1932601317 Detroit 5301011166 8/5/2020 MDHHS-OIG Suspended Synergy Home Services Saunders- Summary Corporation Davenport Khadisha Home Help Agency Southfield 3/30/2021 MDHHS-OIG Suspension
Taylor Medical and Substance Suspended/T Abuse Clinic Group 1386974335 Taylor 7/3/2013 DCH-OIG 4/15/2014 DCH-OIG erminated Summary The Pain Center USA PLLC Group 1508996653 Warren 12/26/2018 MDHHS-OIG Suspension Summary The Pain Center USA PLLC Supplier 1891015160 Warren 12/26/2018 MDHHS-OIG Suspension Tower Dental Care Group 1306019609 Detroit 2/18/2010 HHS 1128(b)(8) Summary Suspension Summary Tri County Physician Group Group 1386942035 Detroit 2/7/2017 MDHHS-OIG 12/18/2017 MDHHS-OIG Suspension Summary Tri State Physicians Group PC Group 1033654595 Detroit 11/12/2017 MDHHS-OIG Suspension Trust Care Clinic PLLC Group 1053461848 Davison 6/18/2015 DCH-OIG Suspended Summary Universal Grace Pharmacy Pharmacy 1417328436 Warren 5301010751 11/9/2020 MDHHS-OIG Suspension Universal Home Medical Equipment & Supplies LLC Supplier 1730334939 Livonia 4/26/2016 CMS Revoked Summary Universal Pharmacy Pharmacy 1700057726 Warren 5301008817 11/9/2020 MDHHS-OIG Suspension
MI-Licensing Controlled and Substance Regulatory license Universal Pharmacy of Saginaw Pharmacy 1568868305 Saginaw 5315068278 4/11/2018 Affairs suspended Summary Suspension Urban Health Care Group PLLC Group 1629449152 Southfield 8/15/2018 MDHHS-OIG 9/14/2018 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing Licensing and Revocation Regulatory and Summary Venoy Nursing Center Nursing Facility Wayne 5/6/1998 Affairs Suspension
Vernor MC Inc Medical Group 1871720342 Detroit 4/15/2020 MIDHHS-OIG Termination Suspended Visiting Doctors of America PC Group 1659519981 Southfield 7/30/2013 DCH-OIG 11/13/2018 MDHHS-OIG Terminated
MI-Licensing and Regulatory Voluntarily Vital Pharmacy Pharmacy 1801947791 Dearborn Heights 5301005762 3/15/2019 Affairs Surrendered Washington Blvd. Dental PC Dental Group Detroit 8/31/2007 HHS 1128(a)(1) Summary Wayne Campus Pharmacy Pharmacy 1760767974 Detroit 11/4/2020 MDHHS-OIG Suspension
Summary Suspension Wayne Pharmacy Pharmacy 1235437807 Detroit 8/30/2011 DCH 7/11/2016 MDHHS-OIG Termination Women's Health Care Specialist PC Medical Group 1447479977 Kalamazoo 7/9/2020 MDHHs-OIG Terminated
MI-Licensing and Regulatory Involuntary Woodward Nursing Center Nursing Facility Detroit 9/20/2004 Affairs Termination Summary Woodward Urgent Care PLLC Medical Group 1861746893 Detroit 7/28/2015 MDHHS-OIG Suspension Summary World Health Care MC LLC Group 1952565160 Detroit 3/21/2013 DCH Suspension Young RehabCo PC DBA Summary Okemos Therapy Services Group 1033225842 Okemos 10/1/2019 MDHHS-OIG Suspension Zagerman Enterprises, Inc. Group GrandVille 10/19/2005 DCH-OIG Suspended
MI-Licensing and Regulatory Aagesen Larry K Dentist 1063572667 Bad Axe 2901009390 7/13/2013 Affairs Suspended Abcumby Keshuna Home Help Auburn Hills 8/21/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
Abdaal John Home Help Commerce Township 10/30/2018 MDHHS Summary Wayne Campus Pharmacy Abdallah Hassan Pharmacy 1760767974 Detroit 11/4/2020 MDHHS-OIG Suspension Summary Abdallah Hassan Pharmacist 1669594099 Detroi 11/4/2020 MDHHS-OIG Suspension Summary Ark Pharmacy Abdelrazzaq Ali Pharmacy 1932502283 Detroit 11/3/2020 MDHHS-OIG Suspension Abuhanieh Ismail Summary Sav-Max Pharmacy Rifai Mahmoud Pharmacy 1982930954 Detroit 5301009202 7/15/2019 MDHHS-OIG Suspension
MI-Licensing and Regulatory Summary Ackerman Jr Robert A Physician 1487630075 North Muskegon 4301077358 5/18/2016 Affairs Suspension Adams Amy Home Help Mount Morris 6/24/2015 DCH Adams Angela Home Help Detroit 7/24/2017 MDHHS Adams Donald Lee Home Help Benton Harbor 11/30/2015 MDHHS Adams Jamal Home Help Detroit 7/6/2017 MDHHS Adams Kenneth Home Help Detroit 3/4/2019 MDHHS Adams Kim Home Help Detroit 2/27/2019 MDHHS Non-Emergency Addison Reginals Transportation Detroit 12/12/2017 MDHHS
Summary Suspension and Crownz Medical Pharmacy Adepoju Adeniyi Pharmacy 1588121875 Warren 5301011544 8/11/2020 MDHHS-OIG Termination Adray Allie A. Chiropractor Dearborn 2301006500 7/4/1996 DCH-OIG 1128(b)(14)
MI-Licensing and Regulatory Adu-Beniako Solomon Physician 1114090511 Livonia 4301084828 5/5/2019 Affairs Suspended Summary Agbebiyi Jonathon A Physician 1588734081 Southfield 4301041053 1/16/2013 DCH-OIG Suspension
MI-Licensing and Regulatory Summary Ahmad Anas Physician 1740595735 East Grand Rapids 4301097387 5/9/2019 Affairs Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Ahmed Asm Akter Physician 1053475814 Hamtramck 4301073086 5/23/2018 MDHHS-OIG Suspension Ahmed Syed Arif Physician Marlette 7/22/1991 HHS 1128(b)(4)
MI- Licensing and Regulatory Affairs MI- Suspended Licensing and Suspended 11/16/2016 Regulatory Summary 11/29/2016 Affairs Suspended 03/31/2017 HHS Excluded Akinwumi Abbey A Physician 1144244708 Detroit 4301071164 7/30/2013 DCH-OIG 10/31/2019 MDHHS-OIG Terminated Akra Darren Home Help Detroit 10/25/2018 MDHHS Akram Aleem Home Help Detroit 6/6/2019 MDHHS
MI-Licensing and Regulatory Alagbe Rosy U. Registered Nurse 1952428179 Grove City, OH 4704281554 6/2/2012 Affairs Suspended Alajrad Muhannad Physician Trenton 4301061516 5/6/1997 HHS 1128(b)(4)
MI- Licensing and Regulatory Summary Affairs HHS- Suspension OIG MI- Summary 08/02/2017 Liceneing and Suspension 9/20/2017 Regulatory Excluded 2/12/18 Affairs Revoked Alam Waseem Physician 1477571818 Bloomfield Hills 4301072403 7/29/2015 MDHHS-OIG 11/8/18 MDHHS-OIG Terminated Alexander Mercedes Home Help Detroit 1/28/2015 DCH
MI-Licensing and Regulatory Summary Alexander Robert L Physician 1265475099 Plainwell 4301044385 11/22/2014 Affairs Suspension Alexander Sharon Denise Home Help Detroit 3/31/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Al-Falahat Nihad Home Help Shelby Township 10/8/2018 MDHHS-OIG Suspension Ali Sekne Home Help Dearborn 4/25/2019 HHS-OIG Alizada Sean Home Help East Lansing 8/6/2018 MDHHS
MI-Licensing and Regulatory Summary Allard Raymond P Physician 1093702607 Sherdian 5101011651 6/24/2020 Affairs Suspension Allen Alicia Home Help Detroit 12/22/2015 MDHHS Summary All About Chores LLC Allen Gary L Home Help Agency Southfield 3/20/2019 MDHHS-OIG Suspension Allen Janice Home Help Nashville 5/8/2018 MDHHS Allen Robert Home Help Detroit 2/22/2016 MDHHS
MI-Licensing and Regulatory Summary Allende-Jimenez Norberto Physician 1285723809 Detroit 4301061931 10/23/2019 Affairs Suspension Allie Christopher Home Help Detroit 5/25/2021 MDHHS Allos Najim Home Help Sterling Heights 11/8/2018 MDHHS Almon Douglas Home Help Novi 1/7/2021 MDHHS Summary Suspension 3/10/2017 MDHHS-OIG Terminated Al-Murisi Verna Home Help Hamtramck 7/13/2016 MDHHS-OIG 6/29/2017 HHS-OIG Excluded
MI-Licensing and Regulatory Summary Affairs Suspension 7/31/2019 MDHHS-OIG Suspended 01/20/2020 HHS-OIG Excluded Alshaikh Nida Dentist 1144407552 Hamtramck 2901018547 12/19/2018 MDHHS-OIG 08/07/2020 MDHHS-OIG Terminated
MI-Licensing and Regulatory Suspended 9/16/2012 Affairs Suspended Alt Nan B. Psychiatrist 1417139692 White Cloud 4301045669 7/18/2013 DCH-OIG 01/20/2016 HHS-OIG Excluded Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Suspended 1/20/2016 Affairs Suspended Alt William J Physician 1912998337 Holland 4301020997 7/18/2013 DCH-OIG 12/29/2016 HHS-OIG Terminated
MI-Licensing Summary and Suspension Regulatory Summmary 2/9/2017 Affairs Suspension 08/20/2017 HHS MDHHS- Excluded Altantawi Bassel Physician 1497797526 Canton 4301074111 6/20/2016 MDHHS-OIG 01/18/2021 OIG Termination Alwajed Zahra Home Help Detroit 9/25/2018 MDHHS-OIG Alyas Arkan Home Help Sterling Heights 4/11/2016 MDHHS Amerson Kevin Home Help Detroit 5/27/2015 DCH 11/5/02: Violation of Medicaid False Claim Act 9/20/04: U.S. Medical Supply, Inc. Amr Hussein M. Medical Supplier Livonia 11/5/2002 DCH 9/20/2004 HHS 1128(a)(1)
MI-Licensing and Regulatory Andersen Judith C Physician 1073551198 Rochester 4301044420 6/22/2014 Affairs Suspended Anderson Connie Home Help Prescott 5/12/2016 MDHHS Anderson Coy Home Help Redford 5/24/2018 MDHHS
Anderson Dantonetee Home Help Detroit 9/6/2016 MDHHS Anderson Gerald Home Help Detroit 9/21/2017 MDHHS Non-Emergency Anderson Julius Transportation Detroit 4/18/2018 MDHHS Anderson Kelvin Lamont Home Help Detroit 3/24/2015 DCH Anderson Maurcie Home Help Detroit 12/28/2016 MDHHS Anderson Paula Home Help Iron Mountain 1/8/2015 DCH Anderson Rose Home Help Muskegon 8/29/2019 MDHHS Andrews Christian Home Help Detroit 12/6/2017 MDHHS Andrews Glenn Walter Physician Detroit 4301407042 5/26/1997 HHS 1128(b)(4) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Andrews Monda Home Help Ypsilanti 10/22/2018 MDHHS Andrews Quenta Home Help Grand Rapids 1/19/2016 MDHHS Andrews Wunika Kenyetta Home Help Detroit 11/30/2015 MDHHS 8/29/93: 1128(a)(1) 10/11/93: Violation of Medicaid False Claim Ansari Inamul Hag Physician Detroit 4301044238 8/29/1993 HHS 10/11/1993 DCH Act
MI-Licensing and Regulatory Suspended Anthony Kirk J Podiatrist 1144330556 Grand Rapids 5901400050 5/25/2013 Affairs 7/18/2013 DCH-OIG Suspended Anthony Tora Home Help Detroit 11/30/2015 MDHHS Antoin Firas Home Help Sterling Heights 4/8/2020 MDHHS Anuskziewicz Michael Home Help Port Huron 10/4/2016 MDHHS Aranda Raul E. Physician Detroit 4301038425 3/15/1990 HHS 1128(b)(3) Non-Emergency Araujo Mario Transportation Holland 7/20/2017 MDHHS Archbold Donna Home Help Harrison 10/11/2018 MDHHS
Summary Raymond & Suspension Elite Wellness LLC Arias Emelitza Physician Group 1174765515 Westland 5/29/2012 DCH 10/17/2013 DCH-OIG Termination Armola Adam Home Help Alma 7/31/2018 MDHHS Armstead Candis Home Help Detroit 8/19/2019 MDHHS 8/19/2019 Armstead Cory Home Help Ypsilanti 11/20/2018 MDHHS Armstrong Clifford Home Help Warren 8/24/2020 MDHHS Arnold Clifton Home Help Grand Rapids 3/18/2019 MDHHS Arnold Pearl R Home Help Jackson 12/7/2020 MDHHS
11/28(a)(3) Summary 05/24/2012 DCH-OIG Suspension Arnold William J. Physician Detroit 4301015572 9/19/2002 04/07/2015 DCH-OIG Termination Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason 8/29/94: Violation of Medicaid False Claim Act 4/10/96: Aronoff Joanne Medical Supplier Detroit 8/29/1994 4/10/1996 1128(b)(5)
Action Sales & Rental Company Aronoff Larry Medical Supplier Detroit 10/24/1989 HHS 1128Aa Asbury Arnita Home Help Eastpointe 2/9/2015 DCH Summary Access Care Home Care, Inc Ashford Falusic Patient Recruiter 1134174006 Ypsilanti 5/22/2012 DCH Suspension Summary Acton Rental & Sales Company Ashford Falusic Employee Ypsilanti 5/22/2012 DCH Suspension
MI-Licensing and Regulatory Affairs Suspended MI-Licensing Summary and Suspension 8/5/2015 Regulatory Summay 10/30/2015 Affairs Suspension Ataya Hatem M Physician 1881664829 Davison 4301079461 6/18/2015 DCH-OIG 07/19/2017 HHS-OIG Excluded Atkins Irvin Home Help Grand Rapids 11/22/2016 MDHHS
MI-Licensing and Regulatory License Atluri Sunitha Physician Auburn Hills 4301062120 3/21/2007 Affairs Suspended
Summary Suspension and Atri Manohar Physician 1346242591 Saginaw 4301406605 12/23/2019 MDHHS-OIG Termination
MI-Licensing and Regulatory Summary Attanasio Franco A Physician 1760453930 Saint Clair Shores 4301057789 12/19/2019 Affairs Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Attar Fakruddin Physician 1114968419 Livonia 4301067384 9/19/2017 MDHHS-OIG Suspension August Jeffrey A. Podiatrist Clawson 5901001206 10/22/1991 HHS 1128(b)(4) Austin Madron Home Help Ypsilanti 8/1/2019 MDHHS Autman Nicole Home Help Jackson 10/26/2017 MDHHS Avant Edward Home Help Detroit 11/12/2019 MDHHS Terminated
MI-Licensing and Suspended Regulatory Summary 1/21/2016 Affairs Suspension Sam- 05/05/2016 MDHHS-OIG Terminated Awada Hussein Physician 1811984594 Warren 4301079394 7/3/2013 DCH-OIG 06/20/2016 HHS Excluded Summary Suspension 11/6/2018 MDHHS-OIG Terminated Awerbuch Gavin Physician 1811984487 Saginaw 4301405226 6/19/2014 DCH-OIG 4/18/2019 HHS-OIG Excluded Summary Maecenas Health Systems Awusah Solomon Group 1003155607 Southfield 8/14/2018 MDHHS-OIG Suspension Summary Awusah Solomon Physician 1922245083 Southfield 4301093171 8/14/2018 MDHHS-OIG Suspension Ayers Antwone Home Help Roseville 2/3/2015 DCH Ayoub Ferris Home Help Sterling Heights 1/30/2017 MDHHS Baber DeMarcus Home Help Saginaw 6/23/2016 MDHHS Summary Backos Eric Physician 1780625251 Warren 4301048249 1/2/2019 MDHHS-OIG Suspension
MI-Licensing and Regulatory Summary Bacon Michael Physician 1912965799 Petoskey 5101006585 5/31/2019 Affairs Suspension
MI-Licensing and Regulatory Bailey Craig Physician 1619106119 Southfield 4301093034 8/23/2019 Affairs Suspended Bailey Melvina Home Help New Haven 1/20/2016 MDHHS Baker Carmen Vietta Home Help Detroit 11/30/2015 MDHHS Baker Marques Home Help Kalamazoo 12/19/2016 MDHHS Balakrishna Banga M. Physician Southfield 4301031899 5/18/2000 HHS 1128(a)(1) Baldwin Demarco Home Help Detroit 10/29/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Baldwin Jr. Milton Home Help Essexville 9/21/2015 MDHHS Ballard Carlton Home Help Kalamazoo 4/21/2016 MDHHS Ballard Ebony Home Help Detroit 10/11/2018 MDHHS Banks Angela A Home Help Jackson 11/30/2015 MDHHS Banks Laron Home Help Southfield 7/3/2019 MDHHS Banks Nolan Home Help Detroit 12/16/2019 MDHHS Banks Willie Home Help Detroit 8/21/2019 MDHHS Bankston Audrea Home Help Port Huron 1/14/2016 MDHHS
MI-Licensing and Regulatory Disciplinary Bansal Sudha Physician 1922053008 Adrain 4301404631 3/17/2021 Affairs Limited Bansil Chyawan K Physical Therapist 1306933908 Lansing 5501002045 3/18/2013 DCH Suspended Barbee Nicholas Home Help New Baltimore 1/23/2020 MDHHS Barclay Roy Home Help Detroit 11/7/2014 DCH
MI-Licensing and Regulatory Barden John H Physician 1669495446 Taylor 5101006701 6/3/2011 Affairs Suspended Bargouthy Sameer Home Help Bay City 5/13/2016 MDHHS Barlow Thomas Home Help Flint 11/8/2018 MDHHS Summary Mary E.Barna DPM & Assoc Barna Mary Medical Group 1598730962 Allen Park 1/19/2021 MDHHS-OIG Suspension Summary Barna Mary Podiatrist 114295510 Allen Park 5901001379 560101/19/2021 MDHHS-OIG Suspension
MI-Licensing Summary and Suspension Regulatory Summary Barna Michael Physician 1508800194 4301051173 1/18/2021 MDHHS-OIG 3/25/2021 Affairs Suspension Barnes Sterling Home Help Saginaw Arcadia 10/2/2018 MDHHS Barnes Terrell Home Help Detroit 4/20/2020 MDHHS Barnett Marshon Home Help Romulus 8/23/2018 MDHHS Barnett Wontoria Home Help Detroit 8/14/2018 MDHHS Summary Barney Gregory Therapist Niles 6401010818 11/3/2020 MDHHS-OIG Suspension Barrera Jesse M Home Help Muskegon 1/5/2016 MDHHS Barrett Althea Home Help Saginaw 7/6/2017 MDHHS Barteran Yvonne Home Help Oak Park 6/30/2021 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI- Licensing and Summary 9/28/2017 Regulatory Suspension 2/12/18 Affairs Revoked Barth Timothy Paul Physician 1356512909 Southfield 4301049340 4/4/2017 MDHHS-OIG 11/29/18 MDHHS-OIG Terminated 4/27/00: Violation of Medicaid False Claim Act 9/20/00: Bartz Nicholas William Physician Jackson 5101008283 4/27/2000 DCH 9/20/2000 1128(a)(a)
MI-Licensing and Regulatory Barudin Barry Physician 1528095585 Greenville 4301032178 11/16/2016 Affairs Suspended
MI-Licensing and Regulatory Affairs HHS Suspended DCH-OIG Suspended 12/8/2014 MI-Licensing Excluded- 0219/2015 and HHS 06/04/2015 Regulatory Terminated Bashir Javaid M Physician 1427071059 Jackson 4301047107 7/3/2013 DCH-OIG 04/10/2015 Affairs Revoked Bass Bernard A Home Help Detroit 11/30/2015 MDHHS Bassett ANgela Home Help Detroit 12/23/2019 MDHHS
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Bastow Bradley D Physician 1346221082 South Haven 5101008849 5/12/2017 Affairs 10/4/2018 Affairs Suspended Bates sabrena Home Help Detroit 2/5/2018 MDHHS Battle Gail Home Help Detroit 8/6/2019 MDHHS Battle Lashannua S Home Help Detroit 4/27/2015 DCH Battle Robert Home Help Twin Lake 3/13/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Baul Terry Scott Physician 1942375837 Detroit 4301042171 12/2/2020 MDHHS-OIG Suspension Baxter Jermaine Home Help Detroit 1/17/2019 MDHHS Bayless Jeffrey Home Help Detroit 11/8/2017 MDHHS Baysinger Christopher Home Help Ludington 2/16/2017 MDHHS Summary Bazzi Chadi Pharmacist 1578096947 Hamtramck 5302031084 8/7/2018 MDHHS-OIG Suspended Better Care Neighborhood Summary Pharmacy Bazzi Chadi Pharmacy 1891801890 Hamtramck 5301008106 8/7/2018 MDHHS-OIG Suspended
MI-Licensing and Regulatory Beale, Jr James Physician 1316934409 Southfiled 4301035963 5/22/2016 Affairs Suspended Beale, Jr Raymond Home Help Detroit 11/14/2016 MDHHS Bean Dominique Home Help Detroit 10/13/2014 DCH Beard Rodney Home Help Detroit 3/23/2015 DCH Beard Tanya Home Help Detroit 12/20/2017 MDHHS Bearden Michael Home Help Detroit 8/17/2017 MDHHS Bearden Tiffany Home Help Roseville 8/28/2017 MDHHS Beasley Jermaine Home Help Belleville 10/5/2017 MDHHS Beasley Rogers Home Help Detroit 10/13/2017 MDHHS Bedell Michael Home Help Detroit 8/30/2018 MDHHS Beebe Michael Home Help Marion 4/25/2018 MDHHS Beech Melvin Home Help Grand Rapids 7/27/2016 MDHHS Beecham Paula Home Help Detroit 11/12/2014 DCH Summary Afzal Beemath MD PC Beemath Afzal Group 1972946580 Lathrup Village 11/27/2018 MDHHS-OIG Suspension
MI-Licensing and Summary Regulatory Suspension Beemath Afzal Physician 1427226737 Lathrup Village 4301085743 11/27/2018 MDHHS-OIG 2/27/2020 Affairs Suspended Summary Behnan Richard A Podiatrist 1306924337 Clarkston 5901001092 3/25/2013 DCH Suspension Belcher Brandy Home Help Port Huron 9/17/2020 MDHHS Bell Deangelo Home Help Flint 11/19/2015 MDHHS Bell James E Home Help Benton Harbor 3/23/2015 DCH Bell Omar Home Help Detroit 5/7/2018 MDHHS Bellamy Emmanuel Home Help Southfield 1/19/2016 MDHHS Bellamy Herbert Home Help Sterling Heights 11/30/2015 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Summary Bellinger Thomas M Physician 1457316655 Freeland 4301406493 5/10/2015 Affairs Suspension Bellman Galen Home Help Vassar 9/10/2018 MDHHS Eaton Manor, Inc Benisatto Salvatore D. Nursing Facility Charlotte 7/20/2004 HHS 1128(a)(1) Benjamin Corncella Home Help Kalamazoo 1/26/2021 MDHHS
Summary Suspension and Bennett Chas Chiropractor 1063423671 Kawkawlin 2301009215 4/27/2020 MDHHS-OIG Termination
MI-Licensing and Regulatory Bennett Derek K. Private Duty Nurse 1770022873 Highland Park 4704180735 2/21/2020 Affairs Suspended 1/24/94: Violation of Medicaid False Claim Act 8/10/94: Inkster Pharmacy Bennett Donald J. Pharmacy Inkster 5301004725 1/24/1994 DCH 8/10/1994 1128(a)(1) Non-Emergency Bennett Tara Transportation Kincheloe 6/8/2017 MDHHS Non-Emergency Benson Anthony Transportation Adrian 8/15/2019 MDHHS Benson Arthur Home Help Lansing 4/27/2021 MDHHS Bentley Melvin Home Help Detroit 12/5/2017 MDHHS Beothers Melinda Home Help Melvindale 9/16/2019 MDHHS-OIG Berbaum Gerald L. Chiropractor Brighton 2301002246 5/20/2001 HHS 1128(a)(3)
MI-Licensing and Regulatory Voluntarily Bergman Gary D Physician 1740272061 Farmington Hills 4301024824 5/18/2016 Affairs Surrendered Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Summary Bergman Steven Paul Physician 1699739177 Caledonia 5101008850 10/3/2008 Affairs Suspension Bergran Harvey A. Physician Muskegon 5101005122 6/28/1992 HHS 1128(b)(3) Berk Richard I. Podiatrist Ann Arbor 5901001060 11/7/2000 HHS 1128(b)(4) Summary Conant Plaza Pharmacy LLC Berri Samir R Pharmacy 1437202587 Detroit 5301007843 5/22/2018 MDHHS-OIG Suspension Berri Samir Summary Buckley's Pharmacy 103 Cole Anthony Pharmacy 1902148356 Warren 5301010625 5/22/2018 MDHHS-OIG Suspension Berri Samir Cole Anthony Summary Buckley's Pharmacy 104 Hamka Ghassan Pharmacy 1922421528 Detroit 5301010311 5/22/2018 MDHHS-OIG Suspension Berri Samir Cole Anthony Summary Buckley's Pharmacy 102 Rahman Shamimur Pharmacy 1962764506 Hazel Park 5301009840 5/22/2018 MDHHS-OIG Suspension Berri Samir Cole Anthony Summary Buckley's Pharmacy 105 Rahman Shamimur Pharmacy 1861882599 Warren 5301010625 5/22/2018 MDHHS-OIG Suspension Suspended 5/18/2017 HHS Excluded Berry Alphonso Physician 1770553521 Farmington Hills 4301053422 7/30/2013 DCH-OIG 10/29/2018 MDHHS-OIG Terminated Berry Corinthian Home Help Detroit 11/5/2015 MDHHS
MI-Licensing and Regulatory Beseau Catherine Rebecca Physician 1194820068 Union Lake 4704226477 5/14/2009 Affairs Suspended Besemer Mikelle Home Help Cedar Springs 2/3/2015 DCH Bessey Vicki Jo Home Help Grand Rapids 11/5/2014 DCH Betro Jospeh Physician 1326026006 Novi 5101009687 10/15/2017 MDHHS-OIG Suspended
MI-Licensing and Limited Regulatory License Beyer Rogers Physician 1295718138 PawPaw 4301046890 2/6/2020 Affairs 7/9/2020 MDHHS-OIG Terminated Summary Bhargava Ajay Physical Therapist 1669588018 Okemos 5501005343 10/1/2019 MDHHS-OIG Suspension Biddles Marquis R Home Help Detroit 2/25/2021 MDHHS Bigham Brian Home Help Muskegon 8/16/2021 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason 4/12/01: Violation of Medicaid False Claim Act 9/20/01: Bilani Sami Suheil Dentist 1821140187 Hamtramck 290116822 4/12/2001 DCH 9/20/2001 1128(a)(1) 4/12/01: Violation of Medicaid False Claim Act Bilani, Sami S., DDS, PC (aka 9/20/01: Family Dentist PC) Bilani Sami Suheil Dental Group Hamtramck 4/12/2001 DCH 9/20/2001 1128(a)(1) 4/12/01: Violation of Medicaid False Claim Act 9/20/01: First Care Hamtramck Dental PC Bilani Sami Suheil Dental Group Hamtramck 4/12/2001 DCH 9/20/2001 1128(a)(1) Billups Sherman Home Help Oak Park 5/22/2017 MDHHS License Bischoff William H. Chiropractor Fenton 2301002126 12/22/1991 HHS Revocation Bivens Dontae Home Help Detroit 11/14/2016 MDHHS Black Andrea Home Help Detroit 2/3/2016 MDHHS Black Arvin D Home Help Dowagiac 3/6/2015 DCH Black Christopher Home Help Inkster 5/30/2019 MDHHS Black Ebony Home Help Grandville 1/20/2021 MDHHS Black Kakeshia Home Help Detroit 11/7/2019 MDHHS Black Lawrence Home Help Detroit 5/19/2015 DCH Rehabilitative Counseling and Summary Behavioral Black Regina Group 1366785032 Clinton Township 5/22/2020 MDHHS-OIG Suspension Black Tasha Home Help Kalamazoo 11/30/2015 MDHHS Blackbey Anthony Home Help Detroit 12/4/2018 MDHHS Blackburn Patricia Ann Home Help Port Huron 6/2/2015 DCH Blackmon Kariaba Home Help Muskegon 8/11/2015 MDHHS Blackshear Jameel Home Help Detroit 3/7/2019 MDHHS Blair Patrick E Home Help Niagara 2/5/2015 DCH Blakeley Courtney Home Help Grand rapids 8/2/2017 MDHHS Blakney Donald William-Ch Home Help Vermontville 4/10/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Blanding Richard L. Dentist 1760665806 Detroit 2901010938 7/3/1988 HHS 1128(a)(1)
MI-Licensing and Regulatory Blanzy Edward Anthony Physician 1740332600 Allen Park 5101010788 12/6/2007 Affairs Suspended Bledsoe Dayon Home Help Pontiac 3/22/2017 MDHHS Blevins Michael Home Help Grand Rapids 11/29/2018 MDHHS Blunt Darron Home Help Detroit 3/27/2019 MDHHS Violation of Medicaid Podiatrist/Medical False Claim Bobb-Semple Hubert Supplier Highland Park 5901000976 11/12/1990 DCH Act Summary Suspension Body Tony Home Help Detroit 7/23/2019 MDHHS-OIG 8/22/2019 MDHHS-OIG Terminated Boggon Taryn Home Help Detroit 6/21/2016 MDHHS Bohn Lindsey Home Help Port Huron 2/18/2016 MDHHS Summary Suspension Ashok Boinpally MD PC Boinpally Ashok Group 1871668392 Detroit 4/1/2019 MDHHS-OIG 8/7/2020 MDHHS-OIG Teminated Summary Suspension Boinpally Ashook Physician 1255421384 Detroit 4301055363 4/1/2019 MDHHS-OIG 8/7/2020 MDHHS-OIG Terminated Bolton Dennis Home Help Dearborn Heights 3/27/2015 DCH Bomar Lakisha NEMT Detroit 7/13/2021 MDHHS Bonds Rashimme Omar Home Help Pontiac 11/20/2014 DCH Bonner Sirece Home Help Detroit 11/5/2014 DCH Bonney Connell Home Help Detroit 8/8/2018 MDHHS Booker Earl Home Help Wyoming 2/27/2019 MDHHS Boone Jovan Home Help Detroit 10/3/2018 MDHHS Boone Terrance Home Help Kalamazoo 8/29/2019 MDHHS Summary Suspension 6/15/17 MDHHS-OIG Terminated Bosley Crystal Home Help Saginaw 7/18/2016 MDHHS-OIG 8/31/17 HHS-OIG Excluded Summary Bosquez Gina Home Help Pontiac 4/27/2020 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Bossenbery Stephen Physician 1487680302 Grand Rapids 4301087079 7/15/2013 Affairs Suspended Summary Bothra Rajendra Physician 1497839328 Warren 4301033013 12/26/2018 MDHHS-OIG Suspension Bowden Valerie Home Help Detroit 3/30/2015 DCH
MI-Licensing and Regulatory Bowers Philip CRNA 1376672527 Huntington woods 4704156709 1/12/2017 Affairs Suspended Bowman Daniel Home Help Prescott 3/5/2018 MDHHS Boyd Jermaine Anthony Home Help Kalamazoo 11/30/2015 MDHHS Boykins Rashana Home Help Kalamazoo 5/20/2019 MDHHS 5/5/2021 MDHHS Bradford Christopher Home Help Hamtramck 11/14/2017 MDHHS Bradley Angela Home Help Ferndate 3/9/2021 MDHHS Bradley Korey Home Help Detroit 2/1/2021 MDHHS Bradley John Wesley Home Help Detroit 12/15/2015 MDHHS Bradley Stewart Home Help Detroit 1/25/2016 MDHHS
MI-Licensing and Regulatory Voluntarily Brandel Susan Mary Registered Nurse 1629006929 Grosse Pointe Farms 4704120861 6/7/2018 Affairs Surrendered Brandon Darrall Home Help Kalamazoo 12/15/2015 MDHHS Branham Bradley Willis Chiropractor Coldwater 2301007189 9/20/2001 HHS 1128(a)(3) Branson Reshon Home Help Kalamazoo 3/22/2021 MDHHS Brantley Ruth Home Help River Rouge 2/11/2014 DCH-OIG 7/7/2015 MDHHS-OIG Terminated Brazil Michael J. Physician Riverview 5101012432 10/19/1996 HHS 1128(a)(1) Breckenridge Raymond Home Help Detroit 2/25/2020 MDHHS Brewer Akeem Olajuwon Home Help Saginaw 1/30/2015 DCH Brewer David Home Help Inkster 4/19/2018 MDHHS Brewer Rosetta Home Help Battle Creek 1/7/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Summary Regulatory Suspension Affairs Suspended HHS-OIG Terminated MI-Licensing MI- Licensing Controlled 4301090453 and 5/16/2018 and Substance 5315044736 (CS Regulatory 9/20/2018 Regulatory license only Brewster Mark Physician 1275773046 Birmingham only) 11/27/2017 Affairs 10/10/2018 Affairs revoked Briggs Erran Home Help South Haven 9/12/2019 MDHHS Brimmer Nicole Home Help Grand Rapids 6/26/2019 MDHHS Britt Claudius Home Help Inkster 3/23/2017 MDHHS
Suspended, MI-Licensing Drug and Diversion, Regulatory Mental/Physi Britz Joseph Physician 1811004617 Ludington 4301060161 3/12/2011 Affairs cal Inability Broadnax Olivia Home Help Detroit 11/5/2016 MDHHS Terminated Brock Dameon Home Help Lansing 11/12/2019 MDHHS Brock Holly Home Help Midland 8/19/2021 MDHHS Brockitt Michelle Home Help Fort Gratiot 5/30/2018 MDHHS Brocks Alicia Home Help Muskegon 1/13/2016 MDHHS Brod Jason Stewart Home Help Oak Park 4/28/2015 DCH Brook Reginald Home Help Detroit 4/2/2015 DCH Brooks Donta Home Help Detroit 11/1/2017 MDHHS Brooks Ginger Home Help Detroit 5/14/2021 MDHHS Brooks John C Home Help Detroit 11/30/2015 MDHHS Brooks Pamela Home Help Reed City 12/28/2016 MDHHS Brooks Rebecca Home Help Grand Rapids 4/15/2021 MDHHS Brooks Robert Home Help Detroit 3/19/2019 MDHHS Brooks Sharon Home Help Detroit 3/6/2018 MDHHS Broome Shanequa Home Help Pontiac 3/27/2019 MDHHS Brower Carol T Home Help PawPaw 4/14/2015 DCH Brown Akeem Home Help Flint 5/1/2018 MDHHS Brown Annie Home Help Three Rivers 1/19/2021 MDHHS Brown Anthony Home Help Detroit 1/7/2016 MDHHS Brown Bertha Home Help Detroit 4/14/2016 MDHHS Brown Carema Home Help Detroit 3/20/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Brown Charles T Home Help Jackson 11/30/2015 MDHHS Brown Dennis Home Help Croswell 5/10/2021 MDHHS Brown Derrick Home Help Detroit 1/9/2019 MDHHS Brown Ebony Home Help Detroit 11/16/2015 MDHHS Brown Izell Home Help Detroit 1/19/2017 MDHHS Brown Jaremy Anton Home Help Port Huron 2/5/2015 DCH Brown Koreen Home Help Lincoln Park 10/10/2016 MDHHS Brown Kwan Home Help Monroe 12/8/2015 MDHHS Brown Larry Home Help Eastpointe 12/14/2016 MDHHS Brown Lonnell Home Help Detroit 7/22/2021 MDHHS
MI-Licensing and Regulatory Summary Brown Mark A Dentist 1740208172 Madison Heights 2901013422 11/5/2015 Affairs Suspension Advanced Professional Patient Summary Care PLLC Brown Meiuttenun Group 1083074850 Southfield 8/14/2018 MDHHS-OIG Suspension Summary Medical Home Visits PLLC Brown Meiuttenun Group 1972898369 Southfield 8/14/2018 MDHHS-OIG Suspension Summary Professional Patient Care PC Brown Meiuttenun Group 1740683176 Detroit 8/14/2018 MDHHS-OIG Suspension Summary Brown Meiuttenun Physician 1790793941 Southfield 4301088766 8/14/2018 MDHHS-OIG Suspension Brown Randy Home Help Saginaw 7/27/2016 MDHHS Lansing Meidcal PLLC Brown Remona Group 1316307085 Lansing 2/20/2020 MDHHS-OIG Terminated
MI-Licensing and Summary Regulatory Suspension Brown Remona Nurse Practitioner 1265988653 East Lansing 4704284531 5/17/2019 Affairs 2/20/2020 MDHHS-OIG Terminated
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Disciplinary Brown Scott Physician 1760581383 Lansing 5601002665 5/23/2011 Affairs 5/3/2018 Affairs Limited Brown Steven Deshawn Home Help Romulus 4/21/2015 DCH Violation of Medicaid False Claim Brown Zack B. Physician 1447331160 Detroit 4301036091 10/15/1988 DCH Act Lansing Medical PLLC Brown Remona Urgent Care 1306238241 Lansing 2/20/2020 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Brown-Fagan Lisa Counselor 1700011020 Flint 6401011313 1/21/2020 MDHHS-OIG Suspension Browning Quentin Home Help Southfield 8/2/2018 MDHHS Brubaker Leo D. Physician Muskegon Heights 5101003994 3/21/1990 HHS 1128(b)(4) Bruns Frank Home Help Ypsilanti 5/3/2018 MDHHS Summary Brunt Jason Physician 1619979713 Warren 5101013443 8/17/2020 MDHHS-OIG Suspension Bryant Jermaine Home Help Highland Park 7/27/2016 MDHHS Non-Emergency Buchner Kasy Transportation Alpena 3/23/2017 MDHHS Buckner Billy Joe Home Help Grand Rapids 12/26/2014 DCH Buckner Eric Home Help Ypsilanti 6/11/2019 MDHHS Summary Suspension 9/5/2018 MDHHS-OIG Terminated Budayr Reema Dentist 1972683506 Canton 8/6/2018 MDHHS-OIG 4/18/19 HHS-OIG Excluded Buford Keith Home Help Detroit 11/5/2016 MDHHS Buie Leeshaun Home Help Detroit 11/30/2015 MDHHS Bunn Scott Home Help Wyoming 9/20/2016 MDHHS Burch Michelle Home Help Akron 7/31/2018 MDHHS Disciplinary Limited Burdette III James B. Physician Assistant 1235366162 Southfield 560100221 6/26/2018 MDHHS License Burgin Chandra S Home Help Baldwin 11/30/2015 MDHHS Burke Damarcus Home Help Flint 7/26/2016 MDHHS
MI-Licensing and Regulatory Summary Affairs Suspension MI-Licensing MI-Licensing Summary and and Supension Regulatory 4/14/2015 Regulatory Summary Burke Jeffrey P Physical Therapist 1336141704 Gaylord 5501008037 12/7/2014 Affairs 10/20/2015 Affiars Suspension Burkes Derrick Ramone Home Help Detroit 11/24/2014 DCH Summary Burkes Derricka Home Help Inkster 11/10/2020 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Burman Matthew L. Physician 1427054899 Bloomfield Hills 4301030145 5/2/2009 Affairs Suspended Burrell Johnathan Home Help Mount Clemens 1/20/2018 MDHHS Burton Daniel Home Help Delton 1/7/2016 MDHHS Burton Ericka Home Help Detroit 2/19/2019 MDHHS Burton Jomo Home Help Detroit 9/10/2019 MDHHS Busher Jason Home Help Detroit 6/25/2015 DCH Buszek Robert F. Physician Highland Park 5101006226 10/6/1994 HHS 1128(b)(4)
MI-Licensing and Regulatory Butler Dennis A Dentist 1053499475 Southfield 2901011373 1/24/2013 Affairs Suspended Butler Donzel Home Help Detroit 10/12/2016 MDHHS Butler Earnest Leon Home Help Detroit 1/21/2015 DCH Butler Michael Home Help Detroit 2/20/2019 MDHHS Butler Tony Eugene Home Help Detroit 4/1/2015 DCH
MI-Licensing MI-Licensing and and Regulatory Regulatory Terminated Butler-Jackson Lois Michelle Physician 1508846320 Southfield 4301051182 8/3/2013 Affairs 3/14/2012 Affairs Suspended Byl Danny H. Dentist Potterville 2901013592 8/18/1997 HHS 1128(b)(4) Byrd Antwone Home Help Detroit 11/22/2016 MDHHS
Cain Wilhelmina Home Help Benton Harbor 6/21/2018 MDHHS Cajer Chochon Home Help Detroit 3/23/2017 MDHHS iCare Home Help Agency Caldwell Kevin Home Help Agency Battle Creek 10/1/2019 MDHHS-OIG Terminated Calhoun Lawrence Home Help Detroit 10/9/2018 MDHHS
MI-Licensing MI-Licensing and and Regulatory Regulatory Suspended Call Richard A Physician Assistant 17604249772 Bay City 5601004029 4/22/2019 Affairs 8/20/2020 Affairs Suspended Callahan Keith H. Dentist Flint 2901014674 5/25/1997 HHS 1128(b)(3) Calloway Lowantha HomeHelp Detroit 1/19/2021 MDHHS Caluya Kristina Home Help Grand Rapids 8/6/2019 MDHHS Terminated Camak Toikinte Home Help Detroit 5/17/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Camp Clarence L. Dentist 1649347212 Detroit 2901015197 10/20/1999 HHS 1128(b)(14) Campbell Cavin Home Help Wyandotte 1/21/2017 MDHHS Campbell Jimmy Home Help Pontiac 7/25/2019 MDHHS Campbell Steven K. Physician Flint 4301048115 4/10/1991 HHS 1128(b)(4) Campbell Sylvester Home Help Highland Park 3/25/2015 DCH Cannady Tyronne Home Help Saginaw 9/24/2019 MDHHS Non-Emergency Cantrell Donald Transportation Williamsburg 2/16/2017 MDHHS
Mi-Licensing and Regulatory Capanna Diane CRNA 1457345480 Saint Claire Shores 4704082314 11/11/2018 Affairs Suspended Capriccioso Richard P. Physician Detroit 4301047689 11/11/1992 HHS 1128(a)(2) Carmona Luis M. Home Help Battle Creek 3/3/2021 MDHHS Disciplinary Limited Carothers George G. Physician 1679531669 Grand Rapids 5101005885 6/25/2018 MDHHS License Carpenter Samantha Home Help Hale 12/8/2015 MDHHS Summary Carpenter Thomas Physician 1952301699 Redington Beach, FL 5101010046 8/8/2018 MDHHS-OIG Suspension Carr Nakisia Home Help Detroit 8/17/2016 MDHHS Carr Tyran Home Help Detroit 6/25/2019 MDHHS Carrier Shannon Lyn Home Help Harrison Township 3/23/2015 DCH Carroll Julian D. Home Help Detroit 12/14/2020 MDHHS Carter Aloysous Home Help Detroit 12/19/2019 MDHHS
MI-Licensing and Regulatory Summary Carter Beth A Physician 1962529990 New HAven 4301065530 6/17/2020 Affairs Suspension Carter Corey Home Help Hazel Park 10/27/2017 MDHHS Carter Cornell Home Help Detroit 1/25/2021 MDHHS Carter Gerald Home Help Detroit 3/29/2016 MDHHS Cason Marlon Home Help Detroit 10/26/2020 MDHHS Castelow Tracy Home Help Highland Park 9/16/2019 MDHHS Castleberry Barbara Home Help Augusta 8/29/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Disciplinary Regulatory Limted Castro-Urrutia Fernando Jose Physician 1578580411 Coldwater 4301067134 6/16/2017 Affairs License Caudill Agnes Home Help Stockbridge 4/1/2020 MDHHS Caver Latoya Home Help Detroit 1/6/2016 MDHHS Celestino Karen Home Help Beaverton 5/1/2017 MDHHS
MI-Licensing and Regulatory Chalfant Lance E. Chiropractor 1265491047 Jackson 2301006854 9/20/2013 Affairs Suspended Nu Care Medical PC Cham Harish Physician Group Detroit 5/4/1992 HHS 1128(a)(1) Cham Kirishna Physician Detroit 8/10/1994 HHS 1128(a)(1) Chambers Charlanne Home Help Grand Rapids 11/6/2015 MDHHS Summary Metro Home Visiting Physicians Suspension PLLC Chang Zongli Group 1730373440 Livonia 3/27/2018 MDHHS-OIG 11/1/2019 MDHHS-OIG Terminated
MDHHS-OIG MI-Licensing MI-Licensing and Summary and 3/27/2018 Regulatory Suspension Regulatory 6/14/2019 Affairs Revoked Chang Zongli Physician 1598807547 Livonia 4301087633 5/5/2017 Affairs 11/01/2019 MDHHS-OIG Terminated Chapman Oneal Home Help Saginaw 11/30/2015 MDHHS Charleston Adam Home Help Kalamazoo 11/30/2015 MDHHS Chastang Debra Home Help Detroit 10/10/2016 MDHHS Chatman Kimyatta Home Help Detroit 3/12/2019 MDHHS Chears Ronald Home Help Detroit 3/20/2015 DCH Chears Terrance Benard Home Help Detroit 3/6/2015 DCH Cheathem JaWaun Home Help Detroit 7/17/2018 MDHHS Non-Emergency Cheeseman Jacqueline Transportation DeTour Village 6/19/2017 MDHHS Cherry Joseph B Home Help Muskegon 11/30/2015 MDHHS
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Disciplinary Chinoy Shakeeb Physician 1457410912 Bloomfield Hills 4301087003 7/20/2018 Affairs 4/5/2019 Affairs Limited Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Chism David Home Help Pontiac 1/22/2019 MDHHS Summry Cholag Nofal Pharmacist 1407389570 Warren 5302033146 11/9/2020 MDHHS-OIG Suspension
MI-Licensing Summary and Suspension Regulatory Voluntary Anson Pharmacy Chu Lap Pan Pharmacy 1962818625 Lambertville 5301010542 11/19/2018 MDHHS-OIG 3/15/2019 Affairs Surrendered
Mi-Licensing and Regulatory Voluntarily Chuanromanee Orapin Counselor 152845254 Ann Arbor 6401015108 2/7/2021 Affairs Surrendered
MI-Licensing and Regulatory Voluntarily Chun Kenneth K. Physician 1467511808 Bloomfield Hills 4301038189 9/13/2017 Affairs Surrendered
MI-Licensing and Regulatory Chupka Thomas E Dentist 1790011450 Sault Sainte Marie 2901011891 2/21/2013 Affairs Suspended Church Aimee Home Help Caro 1/27/2018 MDHHS Church Kortez Home Help Saint Claire Shores 5/10/2017 MDHHS Ciesielski Leonard Home Help Bay City 8/11/2015 MDHHS Clark Carla Home Help Grand Rapids 7/14/2016 MDHHS Clark Frank L. Physician Petosky 4301042015 7/8/1993 HHS 1128(b)(3) Clark Gregory Home Help Grand Rapids 12/1/2015 MDHHS Clark Michael Home Help Genessee 4/9/2021 MDHHS Clark Lawrence Home Help Detroit 12/29/2016 MDHHS Summary A Loving Touch Clark Shawnell Home Help Agency Oak Park 7/3/2019 MDHHS-OIG Suspension Summary Clark Shawnell Home Help Oak Park 7/3/2019 MDHHS-OIG Suspension
MI-Licensing Mi-Licensing and Suspended and Regulatory Summary Social Worker and Regulatory 10/4/2019 Affairs Suspension Clark Steven Home Help 1801079686 Saginaw 6801013007 6/10/2019 Affairs 08/07/2020 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Suspension EDM Treatment Center Clark Steven Medical Group 1942484647 Saginaw 2/4/2020 MDHHS-OIG 8/7/2020 MDHHS-OIG Terminated Clay Gladys Home Help Detroit 2/9/2016 MDHHS Clay Jermaine Home Help Detroit 11/29/2016 MDHHS Claybren Tashawn Home Help Roseville 10/17/2018 MDHHS Cleveland Genea N Home Help Romulus 11/30/2015 MDHHS Coates Brenda Lee Home Help Benton Harbor 3/30/2015 DCH Coates Richard Home Help Redford 7/13/2017 MDHHS Cochran Lawrence Home Help Ferndale 4/17/2017 MDHHS
MI-Licensing and Regulatory Summary Cody Stephanie Nurse Practitioner 1477022721 Mt. Clemens 4704287935 12/23/2020 Affairs Suspension Non-Emergency Coffee Marco Transportation Harper Woods 1/3/2018 MDHHS Personalized Family Healthcare Summary PC Cogswell Steven Group 1669646618 Troy 11/21/2018 MDHHS-OIG Suspension
MI-Licensing Summary and Suspension Regulatory Summary Cogswell Steven Physician 1528001922 Troy 4301059909 11/21/2018 MDHHS-OIG 3/7/2019 Affairs Suspension Cohen Abbott B. Podiatrist Alpena 5901001980 8/19/2004 HHS 1128(a)(4) Cohen Stanley B Podiatrist 1326014358 Detroit 5901001139 2/9/2017 HHS Revoked Colbert Marion Home Help Detroit 2/13/2017 MDHHS Non-Emergency Cole Earl Transportation Bay City 1/8/2018 MDHHS Cole Katrina Home Help Grand Rapids 4/18/2016 MDHHS Cole Tamika Home Help Highland Park 10/1/2019 MDHHS-OIG Terminated Cole Diana Home Help Coleman 5/8/2017 MDHHS Coleman Aaron Home Help Detroit 7/26/2021 MDHHS Coleman Darius Home Help Detroit 7/26/2021 MDHHS Coleman Derrick Home Help Detroit 7/8/2020 MDHHS Coleman Donald Home Help Center Lake 9/26/2017 MDHHS Coleman Issac Home Help Pontiac 3/28/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing and and Suspended Regulatory Regulatory Disciplinary Coleman Kendella Counselor 1891190070 Redford 6401014587 5/8/2020 Affairs 1/15/2021 Affairs Limited Coleman Kenneth Home Help Warren 12/2/2016 MDHHS Coleman Ray Home Help Lansing 1/13/2016 MDHHS Coleman Richo Home Help Detroit 1/21/2017 MDHHS
MI-Licensing and Regulatory Colen Chaim Physician 1255548269 Petoskey 4301080334 2/27/2020 Affairs Suspended Coles Arturo Home Help Detroit 12/19/2016 MDHHS Suspended 8/20/2015 HHS Excluded Collazo Luis M Physician 1699849885 Fraser 4301062191 7/30/2013 DCH-OIG 10/29/2015 MDHHS-OIG Terminated Collier Jeffrey Home Help Sault Sainte Marie 7/8/2015 DCH Collingwood Carol Home Help Port Huron 7/10/2018 MDHHS Collins Travell Home Help Ypsilanti 10/31/2016 MDHHS Colvin Diane Home Help Detroit 10/30/2018 MDHHS Conley Cheryl Home Help Detroit 2/3/2015 DCH
MI-Licensing and Regulatory Suspeneded Connors Andrea J Nurse Practitioner 1124212113 Willis 4704239544 10/26/2014 LARA 3/11/2015 Affairs Revoked Conway Terrance Home Help Detroit 4/15/2019 MDHHS Coogan Cary Home Help Inkster 10/8/2015 MDHHS
MI-Licensing and Regulatory Cook Brian W Physician 1790727642 Howell 4301051801 5/17/2013 Affairs Suspended Cook Daniel Home Help Central Lake 10/15/2020 MDHHS
MI-Licensing and Regulatory Cook Dwayne Physician 1447229125 Belding 4301074284 12/26/2017 Affairs Suspended Cook Stephanie Home Help Detroit 5/9/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason 7/20/05: 1128(a)(1) 8/20/07: Cooke Jeffrey S. Podiatrist Centerville 5901001109 7/20/2005 HHS 8/20/2007 HHS 1128(a)(1) Cool Patte Home Help Burton 10/29/2014 DCH Cooper Elizabeth Home Help Lansing 4/1/2015 DCH Cooper Grace Home Help Benton Harbor 11/23/2015 DCH Cooper Judith Home Help Mantisique 1/30/2017 MDHHS Cooper Lorena M Home Help Southfield 11/30/2015 MDHHS Summary Cooper Scott Physician 1215917760 West Bloomfield 4301053306 6/22/2020 MDHHS-OIG Suspension Cordial Amber Home Help Owosso 2/4/2020 MDHHS Corhn Brian Home Help Benton Harbor 11/30/2015 MDHHS Cornelius Denice M. Physician Lansing 5101009416 5/20/2001 HHS 1128(a)(4) Summary Cornfield Robert H DPM Cornfield Robert Group 1790990471 Rochester Hills 12/18/2019 MDHHS-OIG Suspension Summary Cornfield Robert Physician 1295737096 Rochester Hills 5901001495 12/18/2019 MDHHS-OIG Suspension Corradi Martin Home Help Troy 10/29/2016 MDHHS Cortez Samson Home Help Marysville 3/17/2015 DCH Coulter Deniesha Home Help Flint 5/24/2018 MDHHS Counts Anna Marie Home Help Ecorse 2/13/2015 DCH Cowan Arthur Home Help Detroit 1/8/2019 MDHHS Cox Teanne Home Help Detroit 5/16/2019 MDHHS Crawford Keema Home Help Pontiac 3/20/2015 DCH Critchett Thomas Anthony Home Help Port Huron 2/10/2015 DCH Croft Timothy Home Help Detroit 12/12/2016 MDHHS Croskey Kisean Lamar Home Help Pontiac 10/7/2014 DCH Cross Linda K. Physician Lansing 4301041641 10/22/1991 HHS 1128(b)(4) Crothers Monica Home Help Hart 5/12/2016 MDHHS Crouch Tracy L Home Help Frederic 4/30/2020 MDHHS-OIG Terminated Cruz Evangelina Home Help Jackson 8/29/2018 MDHHS Cruz Myrza Home Help Lansing 1/22/2015 DCH Cumberland Mark Home Help Flat Rock 3/28/2019 MDHHS Cummings Almondo Home Help Detroit 12/5/2019 MDHHS
MI-Licensing and Regulatory Cunningham Darrell R Physician 1902998933 Stanton 5101012407 2/6/2013 Affairs Suspended Cunningham Frank Home Help Detroit 8/27/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Cunningham Bryan Home Help Detroit 4/8/2015 DCH Curry Robert Home Help Detroit 4/12/2017 MDHHS Curry Teisha Laann Home Help Highland Park 11/30/2015 MDHHS Curtis Joseph Home Help Romulus 9/21/2017 MDHHS Curtis Ronald Home Help Detroit 12/13/2018 MDHHS
MI-Licensing MI-Licensing Suspended and and Disciplinary Regulatory Regulatory Limited Cusumano Paul Social Worker 1215359948 Clarkston 6801094558 6/21/2018 Affairs 7/21/2018 Affairs Licnese Cutright Monterea Home Help Detroit 4/11/2017 MDHHS
MI-Licensing and Regulatory Cywiak Seymour N. Physician 1780956524 Farmington Hills 5101005504 8/1/2013 Affairs Suspended Czertko George Physician Detroit 4301033892 2/20/2001 HHS 1128(b)(4)
MI-Licensing Suspended and 7/30/2013 DCH-OIG Suspended Regulatory 12/29/2015 MDHHS-OIG Terminated Dababneh Malik H Physician 1306853221 Dearborn 5101009532 4/10/2013 Affairs 01/20/2015 HHS-OIG Excluded
MI-Licensing MI-Bureau of and Licensing and Summary Regulatory 3/3/2016 Regulatory Suspension Dabbagh Mamoun Physician 1962552158 Warren 4301045473 3/3/2016 Affairs 02/10/2017 Affairs Revoked Franklin Center Pharmacy Dakhlallah Abed A Pharmacy 1073958831 Southfield 8/5/2019 MDHHS-OIG Terminated
Springwells Clinical Pharmacy Inc Dakhlallah Abed A Pharmacy 1427167196 Detroit 8/5/2019 MDHHS-OIG Terminated Dallman James H. Physician Muskegon 4301055294 6/17/1999 HHS 1128(a)(1) Dallo Joseph Home Help Petoskey 10/16/2018 MDHHS Summary Dai Care Services LLC Damisch Dildora Home Help Agency Farmington Hills 1/18/2017 MDHHS-OIG Suspension
Milena Care Home Company LLC Damisch Dildora Home Help Farmington Hills 11/15/2017 MDHHS-OIG Summary Suspension Gerald F Daneshvar MD PLLC Daneshvar Gerald Group 1316347917 Warren 7/29/2015 DCH-OIG 9/28/2018 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Bureau of Summary Licensing and Suspension Regulatory Summary Affairs Suspension HHS-OIG Summary 4/20/2018 MDHHS-OIG Suspension 5/21/18 MI-Bureau of Disolved 9/20/18 Licensing and Terminated 9/28/18 Regulatory Terminated Daneshvar Gerald Physician 1548427164 Warren 4301081745 7/29/2015 MDHHS-OIG 2/4/19 Affairs Revoked Danger Pedro Home Help Grand Rapids 4/18/2019 MDHHS
DCH-OIG MI- Suspended Licensing and Terminated 5/26/2014 regulatory Summary 02/24/2015 Affairs HHS- Suspension Daniel Rajat Physician 1336203603 Bloomfield 4301060871 7/11/2013 DCH-OIG 09/20/2015 OIG Excluded Daniels Anthony Home Help Lincoln Park 5/3/2018 MDHHS Daniels Clarence Home Help Detroit 2/10/2016 MDHHS Daniels Reginald Home Help Pontiac 4/28/2015 DCH Daniels Tiffany Home Help Gaylord 2/13/2017 MDHHS Danis Christine Home Help Hastings 8/9/2016 MDHHS Davidson Zyra Home Help Lansing 3/30/2017 MDHHS Summary Davis Brenda M. Home Help Kalamazoo 10/8/2018 MDHHS-OIG Suspension Davis Cassandra Home Help Kalamazoo 12/7/2017 MDHHS Range Transportation Services Non Emergency LLC Davis Darrell Transportation Livonia 8/12/2020 MDHHS Carriage Park Community Summary Services Davis Gene Home Help Agency Romulus 11/21/2018 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI- Licensing and Regulatory Affairs Summary HHS-OIG Suspension MI- Licensing Summary 8/7/2017 and Suspension 9/20/2018 Regulatory Terminated 10/4/2018 Affairs Suspended Davis Horace J Physician 1033126651 Jackson 5101007157 6/29/2016 MDHHS-OIG 12/21/2018 MDHHS-OIG Terminated Davis Joey Jay Home Help Utica 12/18/2014 DCH Davis Jurmel Home Help Detroit 10/22/2015 MDHHS Davis Keshia Home Help Southfield 11/6/2017 MDHHS
Davis Lakeesa Home Help Detroit 5/19/2015 DCH-OIG Termination Non-Emergency Davis Linda Transportation Farwell 5/9/2017 MDHHS Summary Suspension 9/30/20190 MDHHS-OIG Terminated Davis Marcella Home Help Detroit 8/11/2015 MDHHS-OIG 1/20/2020 HHS-OIG Excluded Davis Marcus Home Help Muskegon 10/10/2017 MDHHS Summary Davis Marilyn Home Help Harper Woods 11/11/2014 DCH-OIG Suspension Davis Mishondia Home Help Mount Clemens 3/14/2016 MDHHS Davis Natesha Home Help Saginaw 4/29/2021 MDHHS Davis Norman Home Help Detroit 10/17/2017 MDHHS Davis Omar Home Help Lansing Davis Sabourium Home Help Lansing 1/25/2015 MDHHS Davis Todd Home Help Detroit 6/29/2021 MDHHS Dawkins Telena Home Help Muskegon 11/26/2018 MDHHS Dawood Ghaith Home Help South Field 9/8/2020 MDHHS Dawood Rashawn Home Help Sterling Heights 3/15/2018 MDHHS Day Michael Home Help Roseville 12/9/2014 DCH Day Michelle Home Help Dearborn Heights 1/7/2021 MDHHS Day Norman Home Help Kalkaska 7/2/2019 MDHHS Day Randy Home Help Eastpointe 10/10/2017 MDHHS Day Frank Home Help Detroit 12/28/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Suspension Thumb Physical Medicine & Terminated Rehab De Gunzman Joel Group 1104129303 Bad Axe 9/18/2013 DCH 10/18/2013 DCH Excluded
MI-Licensing and Regulatory Summary De Witt Dana Andre Physician 1124016639 Jackson 5/15/2018 Affairs Suspension Non-Emergency Dean Antonio Transportation Detroit 3/22/2018 MDHHS Dear Trent Home Help Lansing 5/11/2021 MDHHS Deboer Karol Home Help Lawton 6/11/2019 MDHHS
MI-Licensing Summary and Suspension Regulatory 2/9/2015 DCH-OIG Terminated Deck Robert E Optometrist 1437177342 Lake Orion 4901003566 10/30/2014 Affairs 05/20/2015 HHS-OIG Excluded
MI-Licensing and Regulatory Terminated DeGuzman Joel I Physician 1952433963 Dearborn 4301091071 7/18/2013 Affairs 8/15/2013 DCH Suspended Summary Suspension Dehaan Charles Physician 1144392499 Rockford, IL 4301056984 4/15/2014 DCH-OIG 1/10/2019 MDHHS-OIG Terminated Dejesus Robet Home Help VanBuren Twp 12/17/2020 MDHHS
Summary MI-Licensing MI-Licemsing Suspension and and Voluntary Regulatory 7/20/2016 Regulatory Termination Dela Cruz Fanny A Physician 1689742397 Livonia 4301036977 3/4/2016 Affairs 04/20/2017 Affairs HHS Excluded
MI-Licensing and Regulatory Delvecchio Ryan Lee Counselor 1124329222 Livonia 6451016320 6/18/2021 Affairs Suspended Dendy Ronald Home Help Columbiaville 12/19/2016 MDHHS Denno Denise Home Help Grayling 12/7/2015 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing and and Regulatory Regulatory Suspended Derani Mohammad Physician 1902985310 Dearborn 4301045768 8/16/2017 Affairs 12/27/2017 Affairs Revoked Non-Emergency Derosia Steven Transportation Millersburg 3/9/2017 MDHHS Desai Jasubhai K. Physician Highland Park 4301031425 2/27/1997 HHS 1128(b)(4) Desjardins Stephen Home Help Algonac 3/9/2020 MDHHS Temrinated
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Discplinary DeVries Elisha Social Worker 1740624923 Grand Rapids 6801094687 10/11/2018 Affairs 3/26/2019 Affairs Limited Dewalt Alfred Home Help Pontiac 11/30/2015 MDHHS Dewilde Steven B. Physician 1629507975 Plymouth 5101009688 9/20/2005 HHS 1128(a)(4) Terminated Dial, JR. Lino Sevandal Physician 1245228568 Ludington 5101014103 2/22/2012 DCH 8/7/2013 DCH Suspended Diaz Cynthia A Home Help Saginaw 12/2/2016 MDHHS Dick Guy Home Help Detroit 8/17/2016 MDHHS Dickerson Patrick Home Help Lansing 5/1/2015 DCH Dietz Brandon Home Help Alpena 11/17/2016 MDHHS Dillard Alvin Home Help Toledo OH 6/19/2019 MDHHS Dillard Michael Home Help Inkster 12/2/2015 MDHHS Dillon Mary Home Help Detroit 6/13/2019 MDHHS
MI-Licensing and Regulatory Summary Distefano Kellie Physician Assistant 1386609543 Saugatuck 5601002464 4/3/2019 Affairs Suspension Dixon Jamine J Home Help FLint 4/30/2020 MDHHS-OIG Terminated Dixon Moses Home Help Kalamazoo 10/24/2017 MDHHS Dixon Terrance Home Help Ypsilanti 10/15/2018 MDHHS Non-Emergency Dobbs Joseph Transportation Ishpeming 3/9/2017 MDHHS Dody Calvin Home Help Wayne 4/9/2021 MDHHS Donaldson Joaquin Home Help Grand Rapids 4/18/2017 MDHHS Dorris Lisa Home Help Baldwin 10/10/2017 MDHHS Dorris Machelle Home Help Baldwin 4/22/2015 DCH Dorsette Pierre R. Home Help Jackson 12/9/2020 MDHHS Dorsey Ervin Home Help Detroit 7/16/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Dorsey John K. Home Help Detroit 2/24/2021 MDHHS Dorsey Orondey Home Help Detroit 11/30/2015 MDHHS Dotson William Home Help Detroit 7/3/2019 MDHHS Dougovito Michael F. Nurse Newberry 4704107350 4/20/2000 HHS 1128(b)(4)
MI-Licensing and Regulatory Doutherd Lisa Social Worker 1831333509 Lansing 6802074536 11/10/2018 Affairs Suspended Doyle Christopher Lee Home Help Pinckney 6/1/2015 DCH Drawdy Evelyn Home Help Cadillac 1/26/2015 DCH Drewery Lakeycha Home Help Ypsilanti 7/17/2019 MDHHS Dreyfuss Donald S. Physician Bloomfield Hills 5101005825 9/20/2000 HHS 1128(a)(1) Druitt Elizabeth Home Help Monroe 2/20/2019 MDHHS Drumm Randy E. Physician Edmore 5101009214 1/20/2003 HHS 1128(b)(4) Summary Susan Drust NP PLLC Drust Susan Medical Group 1558804674 Noron Shores 2/21/2020 MDHHS-OIG Suspension
MI-Licensing Summary and Suspension Regulatory Summary Drust Susan Nurse Practitioner 1619907722 Muskegon 4704168366 4/25/2019 Affairs 2/21/2020 MDHHS-OIG Suspension Duck Deborah Home Help Eastpointe 3/18/2010 HHS-OIG 3/30/01: Violation of Medicaid False Claim Act 11/20/02: Duckett Bruce Devlon Dentist Flint 2901015928 3/30/2001 DCH 11/20/2002 HHS 1128(a)(1) Dudley Hameen Home Help Grand Blanc 4/25/2019 MDHHS Dudley Janitta Home Help Clarkston 6/20/2018 MDHHS Dudley Kevin Home Help Detroit 2/8/2018 MDHHS Duke Amanda Home Help Litchfield 8/2/2021 MDHHS Dumont Julie Home Help Port Huron 10/14/2019 MDHHS Duncan Melody Home Help Harper Woods 4/6/2020 MDHHS Duskin Charles Home Help Detroit 2/10/2015 DCH Dwight Heath H Home Help Detroit 11/30/2015 MDHHS Abington Family Medical Center Inc. Dyke Edwin Physician Group Detroit 10/12/1993 HHS 1128(a)(1) Plymouth Medical Center Dyke Edwin Physician Group Detroit 10/12/1993 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Eaton Juanita Home Help Detroit 5/28/2019 MDHHS Ebero Milagras Physician 1376552117 Dearborn Heights 7/3/2013 DCH-OIG Suspended 2/26/01: Violation of Medicaid False Claim Act 8/20/01: Eckert Ronald C. Dentist 1851504138 Okemos 2901007642 2/26/2001 DCH 8/20/2001 HHS 1128(a)(1) Eckles Lisa Home Help Eastpointe 12/15/2016 MDHHS Summary Edu Ganiu Physician 1730260423 Warren 4301099612 1/2/2019 MDHHS-OIG Suspension Edwards Eric Home Help Detroit 5/23/2019 MDHHS Edwards Merrell Home Help Detroit 6/14/2018 MDHHS
MI-Licensing and Regulatory Ekeledo Iroham Brown Pharmacy Detroit 5301009352 2/22/2011 Affairs Suspended Ekeledo Discount Pharmacy Ekeledo Iroham Brown Office Manager 1710207626 Kalamazoo 1/19/2012 HHS 1128(b)f El Nichelle Home Help Warren 9/12/2018 MDHHS Summary Suspension 2/20/2017 HHS Excluded Elhorr Ali A Physician 1730379983 Independence, OH 4301080821 5/6/2014 DCH-OIG 11/01/2019 MDHHS-OIG Terminated Summarily Suspended House Calls Physicians PLLC ElHorr Hicham A. Medical Group 1033273008 Allen Park 5/21/2013 DCH-OIG 6/20/2016 HHS Excluded Summary Suspension El-Horr Hicham A Physician 1255314779 Melvindale 4301080756 5/21/2013 DCH-OIG 5/5/2016 MDHHS-OIG Terminated Elia (Cholak) Aziza Home Help Hazel Park 6/20/2019 HHS-OIG Excluded Elliott Robert L. Chiropractor Redford 2301005227 12/20/1998 HHS 1128(b)(14) Elliott Scott Home Help Detroit 11/19/2019 MDHHS Ellis Bernadette Home Help Jackson 3/23/2016 MDHHS Summary Suspended Ellis Christine Home Help Warren 7/17/2019 MDHHS-OIG 8/17/2019 MDHHS-OIG Terminated Ellis Kenya Home Help Warren 5/24/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing Summary and Suspension Regulatory Summary Elrington Errol Glenn Physician 1568469294 Inkster 4301060303 10/22/2013 DCH 4/10/2015 Affairs Suspension
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatiory Summary Elrington Errol G Physician 1568469294 Inkster 4301060303 12/11/2014 Affairs 4/10/2015 Affairs Suspension
Controlled Substance License Only Summary Suspended Enrollment - MI-Licensing not just CS and license Regulatory Summary Pharmacy 4 Less II Emadamerho Belief Pharmacy 1477821775 Detroit 531052950 (CS) 8/22/2018 Affairs 11/19/2018 MDHHS-OIG Suspended Emanuel Esmerelda Home Help Orion 10/22/2015 MDHHS Emerson Marcellus Home Help Saginaw 11/21/2014 DCH
MI-Licensing and Regulatory Voluntary Emerson Paul Howard Physician 1053458638 Taylor 5101010627 4/2/2009 Affairs Termination Ensley Nancy J Physician 1699715060 Duluth, MN 48610 -MN 12/8/2012 HHS & DCH Suspended Ervin Elyah Home Help Detroit 9/12/2017 MDHHS Eskew Jermaine Home Help Warren 6/19/2017 MDHHS Estep Jaimie Home Help Bay City 4/7/2016 MDHHS Estes Johnny Home Help East Lansing 1/21/2017 MDHHS
MI Bureau of Licensing and Suspended Regulatory Summary Estes Michael Physician 1851341499 East Lansing 4301093275 5/6/2020 MDHHS-OIG 6/8/2021 Affairs Suspension Pharmacy/Medical Modern Pharmacy, Inc. Eustice Maurice B. Supplier Onaway 5301002064 5/4/1992 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
9/9/2019 MDHHS Evans Frances Home Help Garden City 8/30/2019 MDHHS-OIG 09/19/2019 HHS-OIG Traverse City Residential Care, Summary LLC Evans Helena Home Help Agency Kalkaska 3/26/2019 MDHHS-OIG Suspension Ewing Calvin Home Help Grand Rapids 11/28/2016 MDHHS Eyestone Amanda Home Help Ludington 2/26/2018 MDHHS Faison Ashlie Home Help Warren 12/14/2017 MDHHS Summary Trudell Pharmacy Fakih Haytham Pharmacy 1699875088 Dearborn 5301006444 1/16/2019 MDHHS-OIG Suspension Summary Dearborn Heights Pharmacy Fakih Nabil Pharmacy 1649389313 Dearborn Heights 5301007481 6/4/2019 MDHHS-OIG Suspension Falls Tiffany Home Help Saginaw 3/13/2018 MDHHS Suspended MDHHS-OIG Terminated MI-Licesning Summary and Suspension 10/21/2015 Regulatory Excluded Fares Adbdelkader H Physician 1083751085 Dearborn 4301043357 11/3/2014 DCH-OIG 10/16/2015 Affairs Revoked Farmer Patricia Home Help Lansing 1/19/2021 MDHHS-OIG
Summary Suspension Farmer Patricia Home Help Lansing 8/6/2019 MDHHS-OIG 1/19/2021 MDHHS-OIG Termination
Farmer (Gaylord) Dena Kathryn Physician 1477655207 Linden 5101012166 12/20/2009 HHS 1128(b)(4) Farrington Michael Home Help Hazel Park 4/26/2018 MDHHS Fason Leroy Home Help Detroit 10/10/2016 MDHHS
Summary Suspension Summary Michigan Hematology Oncology 12/02/2015 DCH-OIG Suspension PC Fata Farid Tanios Group 1801942453 Rochester Hills 8/13/2013 DCH 01/05/2016 DCH-OIG Termination
MI-Licensing and Regulatory United Diagnostics PLLC Fata Farid Tanios Group 1003160755 Rochester Hills 8/6/2013 Affairs Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
Summary Suspension Summary 12/02/2015 DCH-OIG Suspension Fata Farid Tanios Physician 1417065186 Rochester Hills 4301072629 8/13/2013 DCH 01/05/2016 DCH-OIG Termination 7/15/88: Violation of Medicaid False Claim Act 4/18/89: Fattic Grover R. Physician Niles 4301017283 7/15/1988 DCH 4/18/1989 HHS 1128(b)(5)
MI-Licensing and Regulatory Voluntarily Fee Susan C. Physician 1740254879 Antioch, IL 4301047442 7/17/2019 Affairs Surrendered
MI-Licensing and Regulatory Summary Feher Amndrew A Dentist 1477610004 Warren 2901014314 7/27/2020 Affairs Suspension Feketia Brandy Home Help Monroe 12/12/2018 MDHHS Feliciano Nelson Home Help Detroit 8/30/2021 MDHHS
MI-Licensing and Regulatory Feldman James D. Dentist 1457456634 Southfield 2901010597 9/27/2013 Affairs Suspended Felger Voctoria Home Help Reed City 10/24/2016 MDHHS Summary Felters Marguerite Nurse 1851934095 Saginaw 4703120840 1/19/2021 MDHHS-OIG Suspension
HHS-OIG MI- Licensing and Terminated 6/18/2015 Regulatory Excluded Ferguson Richard D Physician 1497812010 Petosky 5101012069 3/16/2015 DCH-OIG 07/24/2015 Affairs Revoked Fernandez Jose A Home Help Detroit 11/30/2015 MDHHS Fernandez Todd Home Help Lansing 12/12/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Fesler Jonthan Home Help Dowagiac 8/17/2017 MDHHS Non Emergency Fields James Transportation Madison Heights 9/4/2019 MDHHS Fikes Derrick Home Help Saginaw 7/26/2021 MDHHS Filcek Denise Home Help Wayland 11/20/2019 HHS-OIG Excluded Finan Tyianne Home Help Detroit 9/8/2021 MDHHS Finch David L Home Help Jackson 11/30/2015 MDHHS Fineis James L Home Help Lansing 4/27/2020 MDHHS Finney Arthur Home Help Flint 10/15/2020 MDHHS 6/22/94: Violation of Medicaid False Claim Act 8/10/94: Weidman Pharmacy Fiorillo Louis J. Pharmacy Weidman 5301002898 6/22/1994 DCH 8/10/1994 HHS 1128(a)(1) Firestone Morey H. Optometrist Dearborn 4901001455 11/19/1997 HHS 1128(a)(2) Fish Deborah Home Help Allegan 9/16/2019 MDHHS Fish Jason Home Help Pontiac 8/17/2017 MDHHS Fisher Alvin Home Help Detroit 8/3/2017 MDHHS Fisher Crystal Home Help Lansing 4/21/2021 MDHHS Fitch Scott Home Help Detroit 3/9/2020 MDHHS Summary Flack Geeta Home Help Wixom 1/11/2021 MDHHS-OIG Suspension Flanery Holly Home Help Ludington 3/3/2020 MDHHS Flemons Eugene Home Help Detroit 12/4/2018 MDHHS Fletcher Joseph Home Help Detroit 5/2/2019 MDHHS Fletcher Robert Home Help Crystal 8/11/2015 MDHHS Floyd Daytrell Home Help Detroit 12/20/2020 MDHHS Floyd-Martin Gerald Home Help Grand Rapids 7/24/2017 MDHHS Folsom Jennifer Home Help Sturgis 9/10/2019 MDHHS Ford Allen Home Help Benton Harbor 12/22/2014 DCH
MI-Licensing and Regulatory Ford Diane Registered Nurse 1720570906 Comstock Park 4704302081 7/2/2019 Affairs Suspended Ford Lakisha Home Help Detroit 11/25/2015 HHS-OIG Excluded Forman Michael Home Help Gaylord 9/16/2019 MDHHS Forster Wenona Home Help Adrian 8/16/2018 MDHHS Forsythe Tina Home Help Monroe 5/16/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason 3/18/87: Violation of Medicaid False Claim Act 4/21/88: Fort Newland C. Podiatrist Detroit 5901000496 3/18/1987 DCH 4/21/1988 HHS 1128(a)(1) Forte Sandra L. Chiropractor Detroit 2301005177 1/6/1997 HHS 1128(b)(14) Non-Emergency Fortner Brian Transportation Alpena 2/27/2017 MDHHS Fortner Sean D Home Help Flint 5/19/2015 DCH Fortune Aaron Home Help Detroit 12/16/2015 MDHHS Fossett Tyrone Home Help Detroit 4/11/2016 MDHHS Foster Charles Home Help Benton Hrabor 8/22/2016 MDHHS Foster Larry Earl Home Help Detroit 5/15/2015 DCH
DCH-OIG MI-Licensing and Regulatory Suspended Affairs HHS Terminated 4/15/2014 MI-Licensing Summary 01/23/2015 and Suspension 03/19/2015 Regualtory Excluded Fowler Carl D Physician 1417989476 Detroit 4301045243 7/3/2013 DCH-OIG 04/10/2015 Affairs Revoked Fox Linda Home Help Kalamazoo 8/11/2015 Fox Theresa Nurse Practitioner 1750855169 Jackson 4704281677 10/12/2019 MDHHS Suspended Frank Brian Home Help Pontiac 8/1/2017 MDHHS Franklin Dshaun Home Help Detroit 5/4/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Bureau of Licensing and Regulatory Affairs Summary MDHHS-OIG Suspension MI-Licensing Summary 3/29/2018 and Suspension 8/31/18 Regulatory Terminated 1/16/19 Affairs Revoked Franklin Jennifer Physician 1013115914 Harrison Township 4301095983 3/31/2016 MDHHS-OIG 7/18/2019 HHS-OIG Excluded Franklin Jon Home Help Lansing 6/13/2019 MDHHS Franklin Shaun Home Help Detroit 4/30/2020 MDHHS-OIG Terminated Franks Kimberly Home Help Mesick 9/17/2019 MDHHS Frantz Danielle Home Help Muskegon 1/23/2019 MDHHS Frazier Marion Home Help Detroit 12/28/2016 MDHHS
Fredal Pharmacy Fredal Thomas Pharmacy Gross Pointe Farms 5301004236 5/23/1994 HHS 1128(b)(3) Freedland Joel E. Physician Lincoln Park 5101007189 8/7/1987 HHS 1128(a)(1) Summary Suspension Freeman Christopher Home Help Loretto 12/18/2018 MDHHS-OIG 1/17/2018 MDHHS-OIG Terminated Freeman Richard F. Physician Detroit 4301026316 5/20/1998 HHS 1128(b)(4) Freeman Sean Home Help Detroit 2/22/2018 MDHHS Freeney Antoine Home Help Southgate 3/28/2016 MDHHS
MI-Licensing and Regulatory Frei Julia Physician 1396738597 Marquette 5101010701 12/27/2019 Affairs Suspended
MI-Licensing and Regulatory Freidl Harold D Physician 1962470435 Kalamazooo 4301036711 1/15/2013 Affairs Suspended Friedman Kenneth M. Dentist Roseville 2901014795 10/20/2003 HHS 1128(a)(2) Frierson Andre Home Help Muskegon 6/8/2017 MDHHS Frye Kenneth W. Physician Byron Center 5101003654 9/2/1997 HHS 1128(b)(4) Fuentes Leo Maupo Physician 1487873303 Detroit 4301034718 10/28/1981 HHS 1128(a)(1) Fulbright Leon Home Help Pontiac 1/23/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Fulghum Tyrone Home Help Detroit 6/27/2019 MDHHS Fuller Damon Home Help Detroit 9/21/2016 MDHHS Funderburg Clinical & Summary Community Services Inc. Funderburg, Jr. Gerald R. Physician Group 1225254279 Detroit 5/29/2012 DCH Suspension
MI-Licensing and Regulatory Fyn Mark Stephen Physician 1669624201 Roseville 4704201153 9/15/2009 Affairs Suspended
MI-Licensing and Regulatory Gaft Richard S Nurse Practitioner 1578626735 Gladwin 4704201154 8/13/2016 Affairs Suspended Gaidhane Virendra Pharmacy Owner 1265503288 Detroit 8/5/2020 MDHHS-OIG Suspended Gaines Tameso Home Help Detroit 12/5/2019 MDHHS Galbriath Donnie Home Help Alpena 11/30/2015 MDHHS Galmore Terry Home Help Lansing 12/31/2016 MDHHS Gamble Keyon Home Help Detroit 11/28/2018 MDHHS
MI-Licensing and Summary Regulatory Suspension Gandy Kyle D Physician Assistant 1154502623 Midland 5601005166 4/15/2016 Affairs 7/20/2016 HHS-OIG Excluded Ganinous Anthony Home Help Detroit 11/14/2017 MDHHS Garcia Curtis Home Help Chesterfield 7/7/2016 MDHHS Garcia Laureen Home Help Lansing 6/13/2019 MDHHS Gardner Sara Home Help Warren 11/30/2015 MDHHS Summary James Garfield DO PC Garfield James Medical Group 1679950489 Fenton 5101009666 1/18/2021 MDHHS-OIG Suspension Summary Garfield James Physician 1235231077 Fenton 5101009666 1/18/2021 MDHHS-OIG Suspension Garlick Kaitlyn Home Help Portlage 8/10/2020 MDHHS Garner James Home Help Warren 4/7/2016 MDHHS Garner Rayshell Home Help Detroit 4/18/2019 MDHHS Garrison Earl Home Help Detroit 12/6/2017 MDHHS Garvie Joline Home Help Charlotte 11/30/2017 MDHHS Garza Veronica Home Help Kalamazoo 12/12/2019 MDHHS Gaskin Antonio Home Help Clinton township 4/22/2019 MDHHS Gatewood James Home Help Warren 11/26/2018 MDHHS Gebhardt Mark James Home Help Houghtan Lake 3/31/2015 DCH 5/10/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Geha, James G. DPM, PC Geha James G. Podiatry Group Madison Heights 5901001042 3/18/1999 HHS 1128(a)(1) George Charles Home Help Three Rivers 10/26/2020 MDHHS George Laheeb Home Help Sterling Heights 8/31/2016 MDHHS George Lisa Home Help Pontiac 3/3/2016 MDHHS
HHS-OIG MI-Licensing and Regulatory Affairs Suspended MI- Licensing Excluded 8/18/2016 and Summary 01/31/2017 Regulatory Suspension 08/07/2017 Affairs Revoked Geralt John A Physician 1972839447 Roseville 4301021869 7/30/2013 DCH-OIG 11/8/2018 MDHHS-OIG Terminated Geter Nancy Home Help Detroit 11/30/2015 MDHHS
MI-Licensing and Regulatory Summary Gherman John Physician 1780626788 Livonia 4301084565 1/28/2020 Affairs Suspension Wayne Campus Pharmacy Ghussin Kindy Pharmacy 1760767974 Detroit 11/4/2020 MDHHS-OIG Summary Susp Gibbs Ebony Home Help Grand Rapids 10/31/2016 MDHHS
Gibbs Katrina Home Help Detroit 11/14/2018 MDHHS Gibson Allen Home Help Detroit 10/30/2018 MDHHS
MI-Licensing and Regulatory Summary Gibson Denzel LPN 1689044786 Detroit 4703114723 1/4/2019 Affairs Suspension Gilbert Willie Home Help Detroit 2/5/2019 MDHHS Giles Jeff Home Help Detroit 11/30/2015 MDHHS Gill Kathy Home Help Flint 8/30/2019 MDHHS-OIG Gill William T Home Help Highland Park 11/30/2015 MDHHS Suspended Gilleylen Lonia Home Help Grand Rapids 8/1/2018 MDHHS-OIG 8/3/2020 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Summary Gillihan Todd M Physician 1255474045 Chelsea 4901004251 10/20/2014 Affairs 2/24/2016 Affairs Suspension Gipson Dion Home Help Detroit 2/8/2018 MDHHS Gipson James E Home Help Saginaw 12/3/2014 DCH Gissantaner Sharon Home Help Detroit 5/31/2019 MDHHS Gist Trevon Home Help Detroit 5/21/2021 MDHHS
MI-Licensing and Regulatory Giuliani James Physician 1821057829 West Bloomfield 5101009193 3/24/2015 Affairs Suspended Glass Michael Home Help Wyoming 9/24/2020 MDHHS Disciplinary Limited Gliha Gregory Physician Assistant 1447389044 Wayne 5601001483 6/26/2018 MDHHS License Glover Jamal Home Help Flint 10/18/2016 MDHHS Glover Michelle Home Help Grand Rapids 7/7/2016 MDHHS Godziashv Summary Godiali Vasso ili Physician 1861572000 Bay City 4301065556 9/30/2015 MDHHS-OIG Suspension Summary Suspension Godoy, Charles MD PC Godoy Carlos Group 1912298902 Livonia 3/31/2016 MDHHS-OIG 10/30/2018 MDHHS-OIG Terminated
MI-Licensing Summary and Suspension Regulatory Voluntary 7/12/2017 Affairs Termination 10/30/2018 MDHHS-OIG Terminated Godoy Carlos Physician 1881654705 Livonia 4301033015 3/31/2016 MDHHS-OIG 5/20/2019 HHS-OIG Excluded Goins Dearlando Home Help Detroit 8/23/2021 MDHHS Suspended Goins Rondy D Podiatrist 1508904798 Detroit 5901001535 6/7/2012 DCH 12/30/2018 HHS-OIG Terminated Goit Anissa Home Help wolverine 2/13/2020 MDHHS Golden Takah Home Help Muskegon 8/23/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulartory Summary Affairs Suspension MI- Licensing and amd Termination 2/14/2016 Regulatory Suspension 05/17/2017 Affairs Suspended 6/20/2018 HHS-OIG Excluded Goldfein Aaron S Physician 1053354787 Dearborn 4301082782 5/6/2014 DCH-OIG 10/31/2019 MDHHS-OIG Terminated Non- Emergency Goldston Eric Transportation Inkster 2/25/2020 MDHHS Summary Medlife Rx Gomaa Mohamed Group 1205282266 Pontiac 10/30/2019 MDHHS-OIG Suspension Summary Gomaa Mohamed Pharmacist 1043758246 Pontiac 5302045121 10/30/2019 MDHHS-OIG Suspension Gomez Alexander R Home Help Pinconning 4/9/2015 DCH Gomez Angelena Home Help Pontiac 10/30/2018 MDHHS Gonzales Edward Home Help Detroit 4/19/2018 MDHHS Gonzalez-Tapia SanJuanita Home Help Lansing 4/24/2015 DCH Goode Girard Home Help Detroit 10/7/2019 MDHHS Gooden laurence Home Help Detroit 12/12/2017 MDHHS Goodman Jaimar Home Help Detroit 9/6/2016 MDHHS Goodwin Krysal Home Help Kenockee 2/17/2021 MDHHS
MI-Licensing and Regulatory Disciplinary Goole Rebecca Nurse Practitioner 1700330974 Vicksburg 4704201123 1/2/2021 Affairs Limited Goosby Jerry Home Help Muskegon 4/16/2021 MDHHS Summary Gordon Carolyn Home Help Flint 6/4/2015 DCH-OIG Supension Gordon Craig Home Help Detroit 3/24/2021 MDHHS Gordon Ken Home Help Lansing 1/7/2016 MDHHS Gorial Susan Home Help Sterling Heights 3/20/2019 MDHHS Summary Goriee Eva Dentist 1821171638 Sterling Heights 2901017438 1/15/2020 MDHHS-OIG Suspension Gorosh Richard P. Podiatrist Lansing 5901001179 2/20/2001 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Gosalakkal Jayaprakash Psychiatrist 1669764627 Grosse Pointe 4301104329 3/31/2021 MDHHS-OIG Suspension Summary Suspension 4/20/2017 HHS-OIG Excluded Gotcher Latrise Home Help Detroit 7/13/2016 MDHHS-OIG 4/27/2017 MDHHS-OIG Terminated Gotham James E. Physician Detroit 4301022173 10/11/1990 HHS 1128(a)(1) Graham Theodore N. Physician Detroit 4301024579 7/30/1990 HHS 1128(a)(1) Gramm Donna Home Help Battle Creek 6/20/2018 MDHHS Gramse Lawrence Home Help Flint 2/26/2015 DCH Grant Kelvin Renald Home Help Detroit 1/14/2015 DCH Grant Tammy Home Help White Cloud 8/23/2017 MDHHS Grappin Brian L. Chiropractor 1003931999 Flushing 2301002891 9/19/2002 HHS 1128(a)(3) Gray Scott Home Help Twining 9/3/2019 MDHHS Gray Vanita Home Help Detroit 1/14/2020 MDHHS Gray William Home Help Detroit 1/14/2015 DCH
MI-Licensing and Regulatory Gray Yev Podiatrist 1821006396 Chicago 5901002069 9/21/2017 Affairs Suspended Gray Steven Home Help Detroit 8/31/2020 MDHHS Green Anthony Home Help Ludington 5/17/2016 MDHHS Green Carlos Home Help Lansing 2/13/2020 MDHHS Green Kejuan Home Help Detroit 7/26/2016 MDHHS Green Kevin Home Help Southfield 3/6/2018 MDHHS Green Lanell Home Help Muskegon Heights 8/6/2019 MDHHS Green Rosezetta Home Help Detroit 9/18/2015 MDHHS Summary Green Toni Nurse Practitioner 1821457615 Harper Woods 4704241199 8/4/2020 MDHHS-OIG Suspension Summary Greenbain Mark Psychiatrist 1326093709 Clinton 4301030022 9/26/2011 DCH Suspension Greenberg William A. Optometrist Harper Woods 4901002254 10/19/2006 HHS 1128(a)(2) Greene Antonio Home Help Kalamazoo 7/10/2015 DCH Greer Arthur C Home Help Muskegon 7/21/2020 MDHHS 9/16/2021 MDHHS Gress Raymond C. Chiropractor Lake City 2301004963 4/10/1997 HHS 1128(b)(14) Summary Suspension Grewal Virinder S Physician 1427202050 Okemos 4301030430 3/21/2013 DCH 12/29/2015 MDHHS-OIG Terminated Griffin Andrae Home Help Eastpointe 8/17/2017 MDHHS Griffin Erma Home Help Battle Creek 10/9/2014 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Griffin Kendricks Home Help Pontiac 2/14/2017 MDHHS Griffin Lonnie Leandry Home Help Pontiac 10/20/2014 DCH Griffin Willedtra Home Help Detroit 5/3/2016 MDHHS Griffith Curtis Evan Home Help Detroit 11/30/2015 MDHHS Grimmitt Joseph C Home Help Westland 11/21/2014 DCH
Summary Suspension Grimshaw Kimberly Home Help Hawks 4/20/2020 MDHHS-OIG 11/6/2020 MDHHS-OIG Termination Grissom Stanley Willis Home Help Muskegon 11/19/2014 DCH Gross Charles Home Help Edwardsburg 3/7/2016 MDHHS Gross Michael Home Help Eastpointe 4/23/2020 MDHHS Gross Paul Home Help Port Huron 10/2/2019 MDHHS Gross Robert Home Help Midland 11/3/2015 MDHHS Gross Tina Home Help Eastpointe 12/5/2019 MDHHS
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Voluntarily Grove Frederick Walter Physician 1538532833 Springport 4301033991 4/25/2018 Affairs 11/14/2018 Affairs Surrendered Grubaugh Lisa Marie Home Help Harrison 6/12/2015 DCH Guerra Robert Home Help Flint 10/20/2014 DCH Guest Noelle Home Help Merritt 7/21/2016 MDHHS Summary Suspension Airport Apothecary Gujarathi Chetan Pharmacy 1831422294 Waterford NCPDP 2373253 8/23/2011 DCH 6/2/2016 MDHHS-OIG Terminated
Summary Suspension Be Well Pharmacy Gujarathi Chetan Pharmacy 1891028759 Berkley NCPDP 2373227 8/19/2011 DCH 5/30/2016 MDHHS- OIG Termination
Summary Suspension Responsible Care Pharmacy Gujarathi Chetan Pharmacy 1861668089 Detroit NCPDP 2371160 8/19/2011 DCH 5/23/2016 MDHHS-OIG Termination Excluded Summary Ramasami 10/9/2018 Suspension Bio-Magnetic Resonance Inc. Gunabalan (Ram) Medical Group 1508860206 Madison Heights 8/20/2017 HHS-OIG 11/8/2018 MDHHS-OIG Terminated Ramasami Michigan Biotech Partners LLC Gunabalan (Ram) Medical Group 1821095472 Allen Park 8/20/2017 HHS-OIG Excluded Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Ramasami Sterling Medical Clinic PLLC Gunabalan (Ram) Medical Group 1275767592 Sterling Heights 8/20/2017 HHS-OIG Excluded Gunner Concetta Home Help Detroit 11/30/2015 MDHHS
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Disciplinary Gupta Narsingh Physician 1538184684 Trenton 4301031119 9/14/2020 Affairs 3/17/2021 Affairs Limited Gutz Donald Home Help Wyandotte 5/12/2016 MDHHS Guyton Jimmie Home Help Detroit 1/7/2016 MDHHS
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Ha Hien D Pharmacist 1306070982 Sterling Heights 5302032761 6/14/2018 Affairs 10/10/2018 Affairs Suspended Haacke Tracy Home Help Alpena 5/10/2016 MDHHS Hakim Marvin Home Help Oak Park 6/13/2017 MDHHS
HHS MI-Licensing MI-Licensing Summary and and Suspension Regulatory 5/18/2017 Regulatory Excluded Hakim Sakina S Physician 1659555621 Lexington, KY 5601005216 3/27/2017 Affairs 4/24/18 Affairs Revoked 12/21/89: Violation of Medicaid False Claim Act 12/17/89: Halaberda Daniel Chiropractor 1437273364 Wayne 2301004191 12/17/1989 HHS 12/21/1989 DCH 1128(b)(1)
MI-Licensing and Limited Regulatory Restricted Hale Angela M Private Duty Nurse 1295194249 Detroit 4703093931 7/4/2020 Affairs License Hall Booker Home Help Lansing 6/17/2015 DCH Hall Bruce Home Help Leonard 12/31/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Summary Hall Claude W Physician 1669404513 Farmington Hills 4301041684 8/30/2017 Affairs 1/17/2018 Affairs Suspension Hall Darline Home Help Detroit 9/10/2021 MDHHS Hall Joey Lee Home Help Redford 2/20/2015 DCH
MI-Licensing Suspended and Summary Regulatory 10/10/2013 DCH Suspension Hallak Kassem M Physician 1629140447 Charlotte 4301062401 12/16/2011 Affairs 11/09/2013 DCH Terminated Halm Steven Home Help Gwinn 6/28/2017 MDHHS Halthon Tony Home Help Detroit 3/30/2017 MDHHS Wayne Campus Pharmacy Hamaed Raef Pharmacy 1760767974 Detroit 11/4/2020 MDHHS-OIG Summary Susp Hamama Nary Home Help Saint Clair Shores 11/3/2016 MDHHS Summary Suspension Hammond-Koskey David Physician Assistant 1871676254 Ludington 5601004543 9/18/2013 DCH 12/20/2014 HHS Excluded United Home Care Providers of Michigan Inc Hammoud Alicia Facility 1386962645 Dearborn 5/7/2020 MDHHS-OIG Terminated Non-Emergency Hampton Harry Transportation Belleville 1/4/2018 MDHHS Hankerson Garland Home Help Detroit 11/26/2019 MDHHS Hanna Nadim Home Help Farmington Hills 11/14/2018 MDHHS Hansen Terry Home Help Port Huron 10/31/2014 DCH Hardon Dawn Home Help Detroit 4/2/2019 MDHHS Hardrick Michael Home Help Detroit 6/26/2018 MDHHS Hardrick Tanya Home Help Detroit 10/19/2016 MDHHS Hardville Travis C Home Help Detroit 6/2/2015 DCH Hardy Andrew Physician 1710101688 Traverse City 4301046774 11/20/2002 HHS 1128(a)(1)
Summary Suspension and Harper George Home Help Eastpointe 7/22/2015 MDHHS-OIG Termination Harper Michael Home Help Pontiac 3/13/2019 MDHHS Harper Samuel Home Help Manistee 3/7/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Voluntarily Harrell Donald Physician 1164592721 Kalamazoo 4301033947 3/17/2021 Affairs Surrendered Harrell Ebony Home Help Detroit 5/11/2017 MDHHS Harrell Pamela Home Help Warren 11/10/2014 DCH Harrell William Home Help Detroit 4/19/2016 MDHHS Harrien Brandon Home Help Muskegon 1/4/2016 MDHHS Harris Antawan Home Help Muskegon 8/22/2019 MDHHS Harris Camaron Home Help Flushing 4/16/2021 MDHHS Harris Cedrick Home Help Three Rivers 3/20/2015 DCH Harris Frank W. Dentist 1578615209 Detroit 2901008049 5/26/1997 HHS 1128(b)(4) Harris Jwyanza Home Help Detroit 1/8/2019 MDHHS Harris Martinez Home Help Warren 11/30/2015 MDHHS Harris Patrice Home Help Benton Harbor 10/10/2018 MDHHS Harris Tracey Home Help Detroit 4/4/2016 MDHHS
MI-Licensing and Regulatory Harris Angela Physician 1093918138 Detroit 4301058258 1/15/2020 Affairs Suspended Harris-Ivey Marion Home Help Flint 4/7/2015 DCH Harsten Kidadah Home Help Detroit 10/29/2016 MDHHS
MI-Licensing and Regulatory Summary Hartsuff Jenni Physician 1972544518 East Lansing 4704178226 10/28/2008 Affairs Suspension Harvey Kelvin Home Help Detroit 9/26/2017 MDHHS Harvey Tamika Home Help Detroit 1/7/2016 MDHHS Hasan Nafeesa Home Help Pontiac 9/19/2017 MDHHS Hasberry Michael Home Help Southfield 12/17/2014 DCH Hasley Samuel Home Help Westland 2/28/2019 MDHHS Hatt Justin Home Help Mount Pleasant 3/16/2021 MDHHS Hatten Towanda Home Help Grand Rapids 11/7/2016 MDHHS Hawkins Brittany Home Help Holland 2/22/2018 MDHHS Hawkins Dale Home Help Detroit 4/21/2021 MDHHS Hawkins Duane Home Help Battle Creek 10/30/2019 MDHHS Hawkins Jahmall Home Help River Rouge 5/15/2019 MDHHS Hawkins Mary Home Help Owosso 9/15/2015 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Hayes Antwaune Home Help Saginaw 12/10/2014 DCH Hayes Eric Home Help Garden City 5/16/2019 MDHHS Hayes Kenneth Home Help Roseville 12/4/2019 MDHHS Hayes Norman Home Help Port Huron 1/18/2018 MDHHS Hayes William Home Help Detroit 3/7/2016 MDHHS Haynes David Home Help Niles 1/14/2020 MDHHS Haynes Demond Home Help Detroit 4/25/2019 MDHHS Head Charles Home Help Detroit 4/15/2019 MDHHS Hearns Ben J. Dentist Detroit 2901014305 2/5/1997 HHS 1128(b)(14) Heath Beverly Home Help Detroit 7/6/2016 MDHHS Heath Lucius Home Help Detroit 5/3/2021 MDHHS Hedgecorth Julia Anne Physician Albion 4301045086 4/2/2001 HHS 1128(b)(4) Heeren Nancy Home Help Grand Rapids 7/25/2017 MDHHS Heidenga Scott Home Help Holland 2/12/2018 MDHHS
MI-Licensing and Regulatory Affairs Summary MI-Licensing Suspension and Summary 6/28/2016 Regulatory Suapension Heiney Jake P Physician 1215081773 Lambertville 35090990 9/15/2015 MDHHS-OIG 02/10/2017 Affairs Revoked Heinze Adam Home Help Cheboygan 11/28/2016 MDHHS Hemphill Robert A. Physician 1073608774 Saginaw 5101006231 8/20/2002 HHS 1128(a)(3) Hendershott Ashley Home Help Cadillac 7/8/2021 MDHHS Henderson Ericka Home Help Mount Morris 4/21/2016 MDHHS
MI-Licensing Summary and Suspension Regulatory Summary Henderson Judy Physician 1700813227 Niles 4301088108 8/31/2020 Affairs 6/1/2021 MDHHS-OIG Suspension Henderson Malik Home Help Detroit 12/4/2015 MDHHS Henderson Phillip John Home Help Detroit 4/21/2015 DCH Henderson Richard M. Dentist North Pontiac 2901006073 2/4/1992 HHS 1128(a)(1) Henderson Sean Home Help Clint Twp 12/1/2014 DCH Henley Yvette Home Help Detroit 5/10/2021 MDHHS Hennemann Duval Home Help Big Rapids 3/10/2020 MDHHS 6/25/2021 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Hennessy Michael E Dentist 1396820460 Farmington Hills 2901014529 12/12/2011 Affairs Suspended Hernandez Jose Home Help Clinton township 5/3/2016 MDHHS Hernandez Laureane Home Help Pontiac 2/6/2015 DCH
MI-Licensing and Summary Regulatory Suspension Herold Arthur D Physician 1982602686 West Bloomfield 5101005640 3/30/2017 Affairs 7/19/2017 HHS-OIG Excluded
MI-Licensing and Regulatory Affairs Summary HHS Suspension MI-Licensing Summary 11/22/2014 and Suspension 12/18/2014 Regulatory Excluded Herrero Adelina W Physician 1740340264 Ypsilanti 4301032776 4/15/2014 DCH-OIG 4/10/2015 Affairs Revoked Herrick Ebony Home Help Grand Rapids 6/21/2017 MDHHS
MI-Licensing and Regulatory Summary Herrick Kirk Hilliard Physician 1942348446 Saginaw 5101004727 12/17/2020 Affairs Suspension
MI-Licensing and Regulatory Hertzfeld Robert James Physician 1932104460 Northwood, OH 4301079137 2/24/2012 Affairs Suspended Hester Anitra Home Help Detroit 10/4/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Summary Affairs MI- Suspension Licensing and Summary Professional 8/15/2019 Regulatory Suspension Hethorn Joseph A Counselor 1114418076 Lansing 6401016668 7/22/2019 MDHHS-OIG 11/26/2019 Affairs Revoked
Ohio Permanently Heyer Geoffrey Psychiatrist 1649200692 Columbus, OH 35091474 5/13/2020 Licensing Surrendered Hibler Anton Deshon Home Help Saginaw 12/9/2014 DCH Hickerson Nicole Home Help Shepherd 2/9/2017 MDHHS Hicks Felicia Home Help Detroit 4/4/2017 MDHHS Hicks Lamont Home Help Dearborn Heights 11/26/2019 MDHHS Higdon Karan Home Help Shelby Township 9/15/2020 MDHHS Higgins Charles Home Help Kalamazoo 7/26/2018 MDHHS Higgwe Golden Goye Podiatrist Southfield 5901001783 10/20/2003 HHS 1128(a)(3) Hijazi Mohamad Dentist Dearborn 2901014717 11/11/1992 HHS 1128(a)(1) Hildebrandt Henry Mark Physician 1124021647 Ypsilanti 4301021381 12/20/2005 HHS 1128(b)(1) Hill Bradley Home Help River Rouge 12/6/2016 MDHHS Hill Jerry Home Help Saginaw 12/2/2016 MDHHS Hill Qunatrell Home Help Inkster 8/29/2016 MDHHS Hill Shawn Home Help Detroit 8/14/2018 MDHHS Summary Tri County Home Help LLC Hill Stephen Home Help Agency Eastpointe 9/10/2019 MDHHS-OIG Suspension Summary Hill Stephen Home Help Eastpointe 9/10/2019 MDHHS-OIG Suspension Summary New Era Home Care Inc Hills Robert Home Health Agency 1740225051 Southfield 5/28/2020 MDHHS-OIG Suspension Suspended and Hines Derrick Home Help Detroit 6/8/2015 DCH-OIG Terminated Hinman Pharmacy (dba Medical Arts Pharmacy) Hinman William Pharmacy Grand Blanc 5301004202 1/3/1989 HHS 1128(a)(1) Hinton Jamar Home Help Sterling Heights 5/30/2019 MDHHS
Vountarily Hintz Laura Nurse Practitioner 1528035342 Saginaw 4704195930 2/2/2017 MDHHS Surrrendered Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Hitz Leticia Home Help Saginaw 7/13/2016 MDHHS Non-Emergency Hoard John Transportation Gladwin 6/28/2017 MDHHS
MI-Licensing and Regulatory Hoberman Melvin Psychologist 1497812523 Dearborn 6361001441 5/2/2021 Affairs Suspended
MI-Licensing and Regulatory Summary Hoch Jeffrey C. CRNA 1215040589 Jackson 4704146933 3/2/2015 Affairs Suspension
Hoda Syed Tanweerul Physician Trenton 4301060045 10/20/2005 HHS 1128(b)(4) Hodge Andrea Home Help Detroit 11/7/2017 MDHHS Hodges Carla Home Help Grand Rapids 4/18/2018 MDHHS Metropolitan Universal Home Care Hodges Telicia Home Help Chicago 1/13/2020 MDHHS-OIG
MI-Licensing and Regulatory Summary MI-Licensing Affairs MI- Suspension and Licensin and Revoked Regulatory 6/26/2018 regulatory Permanently Hoeltzel Mark F Physician 1801910617 Ann Arbor 4301083829 12/21/2017 Affairs 01/15/2020 Affairsg Revoked Summarily Hoffmeister Martin Glenn Physician 1699839365 Grand Rapids 5901001390 2/25/2014 DCH-OIG Suspended
MI-Licensing and Regulatory Hogan Frederick A. Physician 1801974050 Lansing 5101009418 5/24/2010 Affairs Suspended Hogue April Home Help Dowagiac 7/8/2015 DCH Holata Nadher Home Help Oak Park 9/2/2020 MDHHS Non-Emergency Holbrook Angie Transportation Cadillac 9/12/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Summary 3/26/2013 Regulatiory Suspension Holda Michael Physician 1427029925 Howell 4301036662 10/22/2013 DCH 07/20/2015 Affairs Suspended Disciplinary Limited Holen Lawrence Physician 1205936176 Marlette 5101006708 5/31/2018 MDHHS License Holet James Home Help Westland 5/8/2015 DCH Holiday Jermaine R Home Help Grand Rapids 11/30/2015 MDHHS Holliday Sharieffe L Home Help Highland PArk 1/28/2017 MDHHS Holloway Lawrence M. Physician Flint 11/19/1997 HHS 1128(b)(4) Holloway Nathaniel Dentist Ypsilanti 2901006451 8/7/1997 HHS 1128(a)(1) Holmes Eveck Home Help Port Huron 9/5/2018 MDHHS Holmes Mary Home Help Saginaw 8/30/2019 MDHHS-OIG Holston Elizabeth Home Help Warren 8/30/2019 MDHHS-OIG 2/20/2020 HHS-OIG Excluded Holt Joseph Home Help Detroit 1/15/2019 MDHHS Holt Tahitian Home Help Southfield 7/16/2019 MDHHS 12/7/94: 1128(a)(1) 9/7/94: Violation of Medicaid False Claim DCH Act Holyway Craig Taylor Dentist Southfield 2901016274 12/7/1994 HHS 9/7/1994 HHS Excluded Hooks Jermaine Home Help Pontiac 10/11/2017 MDHHS Hooper Bruce Home Help Muskegon 12/3/2018 MDHHS
MI-Licensing and Regulatory Hooper Mary K Registered Nurse 1700076684 Ishpeming 4704244897 11/21/2012 Affairs Suspended Hopkins Bennett Home Help Ecorse 12/7/2017 MDHHS Hopkins Danial Physician Mount Pleasant 4301405717 5/20/2001 HHS 1128(a)(1) Hopkins Danny Home Help Grand Rapids 5/18/2017 MDHHS Hopkins Kenneth R Home Help Pinckney 3/27/2015 DCH Hornaday Richard Home Help Highland Park 11/21/2019 MDHHS Horton Kimberly Home Help Benton Harbor 8/20/2018 MDHHS Houston Jeffery Home Help Grand Rapids 5/23/2019 MDHHS Howard Danny Home Help Rives Junction 9/29/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Howard Demetrius D Home Help Detroit 5/22/2015 DCH Howard Earl Home Help Detroit 11/15/2017 MDHHS Howard Fred Jerome Home Help Gobles 3/25/2015 DCH Howard Lillardo Home Help Flushing 12/12/2016 MDHHS Howard Terrence Home Help Detroit 12/16/2015 MDHHS Howard Timothy Devon Home Help Lansing 3/6/2015 DCH Violation of Medicaid False Claim Howe Clarence G. Physician Detroit 5101003031 3/18/1987 DCH Act Howell Monica Home Help Bay City 9/7/2017 MDHHS Huddleston Shannon Home Help Benton Harbor 5/31/2017 MDHHS Huddleston Sheila Diane Home Help Detroit 10/22/2014 DCH Hudgens Rickey T Home Help Detroit 7/8/2021 MDHHS Hudson Donald L. Chiropractor 1255488615 East Lansing 2301005765 2/2/2006 HHS 1128(b)(14) Hudson James Home Help East Lansing 5/9/2019 MDHHS Huestis Christina Home Help Bay City 10/20/2014 DCH Hughes Timothy Home Help Belleville 11/30/2015 MDHHS Hughey Danny Home Help Muskegon 5/1/2014 DCH Hugle Alden Home Help Detroit 10/17/2016 MDHHS Hulburt Melissa Home Help Jackson 12/27/2016 MDHHS Hunter Earnest D Home Help Monroe 12/8/2020 MDHHS 3/18/87: Violations of Medicaid False Claim Act 10/13/90: Hunter Elleen E. Physician Mount Clemens 5101004385 3/18/1987 DCH 10/13/1990 HHS 1128(a)(1) Hunter Mandell Home Help Jackson 11/5/2020 MDHHS Hunter Tyrone R Home Help Warren 12/7/2020 MDHHS Hurrle Albert Home Help Dowagiac 12/2/2019 MDHHS Non-Emergency Hush George Transportation Afton 1/6/1997 HHS Excluded
MI-Licensing and Summary Regulatory Suspension 8/11/2015 Affairs HHS- Summary 05/19/2016 OIG MDHHS- Suspension Hussain Murtaza Physician 1043238421 Detroit 4301057047 4/6/2015 DCH-OIG 06/02/2016 OIG Excluded Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Hussett Earl Pharmacist 1528629706 Canton 5302410793 3/26/2020 Affairs Suspension Hussey Clifford Home Help Detroit 8/6/2019 MDHHS Huynh Thanh Home Help Grand Rapids 7/12/2016 MDHHS
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Summary Hyde Thomas Dentist 1356402077 Saginaw 2901014309 4/24/2015 Affairs 6/11/2015 Affairs Suspension Hydrick Robert H. Physician Grand Rapids 4301019228 5/20/1998 HHS 1128(b)(4) Hyman Samuel J. Physician Wayne 4301012805 6/30/1988 HHS 1156(b) Hysaw Denise Danillie Home Help Muskegon 12/26/2014 DCH Imam Bashar Managing Employee Dearborn 9/20/2017 HHS-OIG Excluded Non-Emergency Ingram Deonte Transportation Detroit 2/20/2019 MDHHS Ingram Kimberly Home Help Detroit 7/20/2016 MDHHS Inman Tonya Home Help Houghton Lake 2/20/2020 MDHHS Irvin Kresha Home Help Detroit 10/2/2018 MDHHS Summary Suspension 3/28/2019 MDHHS-OIG Terminated Issak Neeran Home Help Sterling Heights 10/8/2018 MDHHS-OIG 4/18/2019 HHS-OIG Excluded Iverson Tracey Lorene Home Help Port Huron 1/12/2015 DCH
Ivory Jackie Home Help Bruceton Mills, WV 6/30/2016 HHS-OIG
MI- Licensing and Suspended Regulatory Summary 3/20/2017 Affairs Suspension Iyer Ravi Physician 1467493791 Detroit 4301082017 7/30/2013 DCH-OIG 11/13/2018 MDHHS-OIG Terminated Jackson Cassandra P Home Help Detroit 12/11/2014 DCH Summary Jackson Chiropractic Clinic Jackson Charles Medical Group 1114111572 Grand Blanc 6/25/2019 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing Summary and Suspension Regulatory Summary Jackson Charles Chiropractor 1508985250 Grand Blanc 2301003001 4/19/2019 Affairs 6/25/2019 MDHHS-OIG Suspension Jackson Darryl Home Help Detroit 11/9/2017 MDHHS
Suspension and Jackson Douglas Home Help Lansing 12/25/2019 MDHHS-OIG Termination Jackson James Home Help Grand Rapids 2/19/2015 DCH Jackson Lakeya Home Help Saginaw 9/29/2017 MDHHS Jackson Latoya Nicole Home Help Detroit 4/13/2015 DCH Jackson Mark Home Help Detroit 2/27/2017 MDHHS Jackson Raymond Home Help Detroit 6/3/2020 MDHHS Jackson Rodney Home Help Kalamazoo 1/21/2020 MDHHS Terminated Jackson Timeko Home Help Flint 1/30/2017 MDHHS Jackson Wanda Home Help Detroit 7/31/2015 MDHHS Jackson Yashica Home Help Warren 2/7/2020 MDHHS-OIG Terminated Jacobs Jerome Home Help Detroit 12/28/2016 MDHHS Jacobson Suzanne Home Help interlochen 10/20/2017 MDHHS-OIG Jadan Raman Home Help Sterling Heights 8/6/2018 MDHHS Jakubiak Paul J. Physician Lansing 4301027820 3/20/2003 HHS 1128(b)(4) Jamar Marnez Home Help Eastpointe 11/30/2015 MDHHS James David Home Help Saginaw 8/17/2017 MDHHS James Marilyn Home Help Lansing 1/26/2017 MDHHS James Yakeena K Home Help Detroit 11/30/2015 MDHHS Jamison Raymond Home Help Niles 5/22/2018 MDHHS
MI-Licensing and Regulatory Janarthanan Sailajah Physician 1811098247 Troy 4301093872 2/19/2013 Affairs Suspended Summary Suspension Janviriya Vicha Physician 1174603930 Southfield 4301032436 3/11/2015 DCH-OIG 1/20/2016 HHS-OIG Excluded Jarvis Kassia Home Help Pontiac 6/26/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Voluntarily Javellana Eronico Physician 1285677948 Bad Axe 4301033553 1/16/2019 Affairs Surrendered Summary Pain Stop MD PLC Jayakar Gandam Medical Group 1306371984 Oak Park 7/17/2019 MDHHS-OIG Suspension Summary Jayakar Gandam Physician 1720017486 Saint Clair Shores 4301036095 7/17/2019 MDHHS-OIG Suspension
MI-Licensing and Regulatory Jayasundera Victor Physical Therapist 1558488783 Southfield 5501005927 9/10/2012 Affairs Suspended Jefferson Lerteatrist Home Help Detroit 12/4/2014 DCH Jeffries Caprica Home Help Covert 1/18/2018 MDHHS Jeffries Willie Home Help jackson 1/30/2020 MDHHS Jenkins Corinna Home Help Flint 12/26/2018 MDHHS Non-Emergency Jennings Alonzo Transportation Westland 1/3/2018 MDHHS Jennings Gregory Home Help Detroit 1/15/2015 DCH Jennings Sophia Loen Home Help Dearborn Heights 11/13/2014 DCH 7/6/93: Violation of Medicaid False Claim Act Podiatrist/Medical 7/29/97: Jerkins Waymon D. Supplier Detroit 5901000834 7/6/1993 DCH 7/29/1997 HHS 1128(a)(1)
MI-Licensing and Regulatory Summary Jimenez Victor Physician 1528045333 Grand Rapids 4301086868 2/9/2021 Affairs Suspension
MI-Licensing and Regulatory Voluntarily Jimmerson-Lee Carolyn Physician 1831152552 Southfield 5101007802 2/6/2020 Affairs Surrendered Johnson Alejandro Home Help Detroit 7/31/2018 MDHHS Johnson Angelo Home Help Detroit 6/10/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Johnson Ben Home Help Detroit 12/10/2020 MDHHS Johnson Bunny Home Help Kalamazoo 2/10/2018 MDHHS MI- Bureau MI-Licensing of Licensing and and Summary Regulatory Regulatory Suspension Johnson Carla Private Duty Nurse 1700397585 Oak PArk 4704195225 2/18/2021 Affairs 7/16/2021 Affairs Suspended Johnson Charles Home Help Pontiac 10/29/2016 MDHHS Johnson Charles Home Help Muskegon 12/9/2015 MDHHS Summary Johnson Denise Home Help Detroit 7/22/2019 MDHHS-OIG Suspension
8/10/2020 MDHHS Johnson Dennis Home Help Detroit 11/21/2018 MDHHS 06/23/2021 MDHHS Johnson Eric Home Help Kalamazoo 12/17/2014 DCH Johnson Erick Home Help Detroit 2/28/2019 MDHHS Johnson Falando Home Help Detroit 10/18/2016 MDHHS Johnson Flossie Home Help Detroit 10/3/2017 MDHHS Johnson Jimmy Edward Home Help Roseville 10/20/2014 DCH Johnson Julius A Home Help Detroit 11/30/2015 MDHHS Johnson Keithley E. Physician Dearborn 4301032641 8/14/1995 HHS 1128(b)(3) Johnson Kisha Home Help Detroit 4/30/2015 DCH Johnson Larry Otis Home Help Detroit 10/23/2014 DCH Johnson Maria Home Help Detroit 8/3/2017 MDHHS Johnson Michael Home Help Kalamazoo 7/17/2018 MDHHS Johnson Robert Home Help Ecorse 4/12/2018 MDHHS Johnson Sandra Nurse Anesthetist 1063440030 Sault Sainte Marie 4704152459 7/5/2019 MDHHS Terminated Johnson Stephen Home Help Lansing 2/9/2016 MDHHS Johnson Tequila Home Help Three Rivers 2/25/2021 MDHHS Johnson Tiaka Home Help Grand Rapids 8/14/2017 MDHHS Johnson Tracy Home Help Kalamazoo 12/23/2014 DCH Healthy Home Living Johnson Naomi Home Help Agency West Bloomfield 11/26/2019 MDHHS Jones Brandon Home Help Harper Woods 11/25/2019 MDHHS Jones Derrick Earl Home Help Wayne 11/30/2015 MDHHS Jones Dmarcus Home Help Roseville 3/16/2015 DCH Jones Geneva Home Help Kalamazoo 5/22/2019 MDHHS Jones George Home Help Benton Harbor 3/18/2019 MDHHS Jones Helen Home Help Detroit 12/18/2014 DCH Jones Henrietta Home Help Port Huron 4/22/2019 MDHHS Jones Ivan Home Help Wayne 7/6/2017 MDHHS Jones Jacquetta Home Help Benton Harbor 8/23/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Jones Jemien Zardo Home Help Flint 4/3/2015 DCH Jones Julias Home Help Milan 11/24/2014 DCH Jones Lacarol Tealette Home Help Detroit 1/23/2015 DCH Jones Lynda Home Help Detroit 7/3/2019 MDHHS MDHHS-OIG Summary MI- License Suspension MI-Licensing and Summary and 5/9/2018 Regulatory Suspension Regulatory 3/22/18 Affairs Revoked Jones Mark Psychologist 1558474585 Port Huron 6301011246 9/5/2017 Affairs 6/8/18 MDHHS-OIG Terminated Jones Marquett Home Help Detroit 11/30/2015 MDHHS Jones Michael Home Help Lannsing 2/18/2020 MDHHS Jones Monique Home Help Grand Rapids 9/14/2016 MDHHS Jones Susan Home Help Jackson 4/15/2019 MDHHS Jones Toberi Home Help Detroit 10/29/2020 MDHHS Jones Turquoise Sabrina Home Help Grand Rapids 2/19/2015 DCH Jones William Home Help Highland Park 7/1/2019 MDHHS Jones- Wert Darlene Home Help Hillsdale 10/6/2016 MDHHS Jordan Brandon Home Help Detroit 9/27/2016 MDHHS
MI-Licensing and Regulatory Summary Joseph Edward Physician 1598719809 Mount Clemens 5101012963 4/4/2008 Affairs Suspension Jude Kevin Home Help Mount Clemens 3/19/2019 MDHHS Judkins Kelvin Home Help Grosse Pointe 9/1/2016 MDHHS Julian Michael Home Help Flint 1/14/2020 MDHHS Terminated Summary Suspension Jurek-D'Andrea Kristina Home Help Macomb 2/19/2014 DCH-OIG 8/26/2015 DCH-OIG Terminated Justice Candy Home Help Mount Clemens 7/23/2018 MDHHS Justice Tyree Home Help Detroit 12/17/2018 MDHHS Kafi Alex Physician 1578586772 Southfield 4301043089 1/20/2020 HHS-OIG Excluded Kalinski Shawn Home Help Detroit 6/5/2017 MDHHS
MI-Licensing and Regulatory Voluntary Kam Anthony M. Physician 1407894207 Sheridan 4301033166 5/1/2008 Affairs Suspension Non-Emergency Kaminski Teresa Transportation Alpena 2/16/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Non-Emergency Karas Kenneth Transportation Lake 5/31/2017 MDHHS
MI-Licensing and Regulatory Voluntarily Kasper Theodore Social Worker 1336271865 Bruce Township 6801059521 11/26/2019 Affairs Surrendered Kassab Sana Home Help Shelby Township 8/20/2018 HHS-OIG Kates Jeremiah Home Help Lansing 1/20/2016 MDHHS 9/19/03: 1128(a)(1) Kaufman, Jack A. DPM, PC (aka 2/20/06: Novi Footcare Associates PC) Kaufman Jack A. Podiatry Group Novi 5901000903 9/19/2003 HHS 2/20/2006 HHS 1128(a)(1) Summary Suspension Noblecare Pharmacy Kaur Prabhjett Pharmacy 1730480203 Southfield NCPDP 2374750 8/23/2011 DCH 6/2/2016 MDHHS-OIG Terminated Kavalick Julie Home Help Croswell 4/25/2019 MDHHS Kay John F. Chiropractor Westland 2301005309 11/8/1994 HHS 1128(b)(14) Violation of Medicaid False Claim Kaza Sudheer Physician Detroit 4301047113 3/18/1987 DCH Act Kazma Robert M. Chiropractor Detroit 2301002964 9/20/2001 HHS 1128(a)(1) Keels Ramone Home Help Saginaw 11/30/2015 MDHHS
Keen-Centofanti Judith R. Chiropractor Imlay City 2301006875 3/6/1997 HHS 1128(b)(14) Kellam Laquinta Home Help Detroit 8/16/2018 MDHHS Kelley Cheryl Ann Home Help Muskegon 12/3/2014 DCH Kelley Demetric Home Help Detroit 5/12/2016 MDHHS Kelley-Manees Cynthia Home Help Eastpointe 2/7/2019 MDHHS Kellum Marlon R Home Help Detroit 11/30/2015 MDHHS Terminated Kelly Paul A Physician 1932351715 Southfield 4301051333 7/30/2013 DCH-OIG 9/30/2013 HHS 1128(a)(1)
MI-Licensing and Regulatory Summary Kelly, Jr. James J. Physician 1316975386 Troy 4201054938 4/27/2008 Affairs Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Voluntarily Kennedy Christopher R Physician 1982665303 Howell 4301076517 7/30/2019 Affairs Surrendered Kennedy David Roderick Home Help Detroit 11/30/2015 MDHHS Kennedy Dominque Home Help Oak Park 4/7/2016 MDHHS All Care Medical Center Inc. Kennedy Donald R. Physician Flint 5101003922 4/12/1993 HHS 1128(a)(1) Kennewell Robert Physician 1083899850 Bloomfield Hills 5101013786 8/3/2020 MDHHS-OIG Suspended Kenue Lakshmi Physician Detroit 4301050782 3/29/1990 HHS Suspended Summary Keri Andrew Physician 1174836571 Warren 5101018617 4/20/2020 MDHHS-OIG Suspension
MI-Licensing and Regulatory Summary Kern Steven A. Chiropractor 1528199403 Marine City 2301005582 8/25/2013 Affairs Suspension
Voluntarily Kerr Ellen Nurse 1588783484 Bloomfield 4704096047 1/5/2011 DCH surrendered Kerse Ladon Home Help Detroit 4/18/2019 HHS-OIG Excluded
MI-Licensing and Regulatory Voluntarily Ketcham Donn W. Physician 1598742702 Allendale 4301023446 2/24/2012 Affairs Surrendered Summary Suspension Terminated Khalil Rami Dentist 1548787997 Northville 2901022252 6/12/2019 MDHHS-OIG 9/2/2019 MDHHS-OIG Excluded
1128(a)(1) Summary 05/06/2014 DCH-OIG Suspension 3/30/2015 DCH-OIG Termination Khan, Walayata MD, PC Khan Walayata A. Physician 1497779649 Ypsilanti 4301042910 2/11/1996 HHS 6/20/18 HHS-OIG Excluded Khanbai Javeed Home Help Lansing 3/23/2017 MDHHS Summary Khreizat Hassan Pharmacist 1972812352 Warren 5302033116 11/9/2020 MDHHS OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Drug Khurana Suresh P. Physician 1790859205 Harrison Township 4301031380 3/18/2011 Affairs diversion
MI-Licensing and Regulatory Summary Kiefer Kathryn M CRNA 1629148119 Grosse Pointe 4704170474 6/9/2017 Affairs Suspension
MI-Licensing and Regulatory Kilpatrick Kerry Chiropractor 1568517225 Grand Rapids 2301004267 10/27/2011 Affairs Suspended Kim Dong Irl Physician Holland 4301039383 6/20/2000 HHS 1128(b)(4) Kimbrel Brandy Home Help Grand Rapids 8/6/2018 MDHHS
MDHHS-OIG MI- Licensing and Summary Regulatory Suspension Affairs Terminated 12/21/2018 HHS-OIG MI- Summary 3/27/2019 Licensing and Suspension 6/20/2019 Regulatory Excluded Kimbrough Christina Physician 1942525894 Canton 430196825 5/1/2018 MDHHS-OIG 12/04/2019 Affairs Revoked Kincaid Shamika Latrice Home Help Southfield 2/17/2015 DCH Summary King Sharon Home Help Detroit 5/27/2020 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MDHHS-OIG MI- Licensing Summary and Suspension Regulatory Terminated Affairs MI- Summary 6/6/2018 Licensing and Suspension 11/13/2018 Regulatory Summary King III John V Dentist 1528142718 Detroit 2901011657 5/7/2018 MDHHS-OIG 08/05/2019 Affairs Suspension Violation of Medicaid False Claim J & J Sleep, Inc. Kingen Jack Physician Group Durand 4/8/2004 DCH Act Kingen Kevin Home Help Redford 8/18/2015 MDHHS Kinsley Tammy Home Help Saginaw 6/4/2021 MDHHS
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Voluntarily Kirchhaine Jr. William Physician 1073558102 Muskegon 4301049279 12/29/2014 Affairs 5/20/2015 Affairs Surrendered Kirkland George Home Help Redford 1/17/2018 MDHHS Kirkland Steven Home Help Detroit 4/12/2017 MDHHS Kiryakoza Mark Home Help Macomb 5/22/2019 MDHHS Kitchen Richard Home Help Muskegon 4/12/2021 MDHHS
Kizer Theoloneus Home Help Benton Harbor 10/24/2017 MDHHS
MDHHS-OIG MI-Licensing and Regulatory Summary Affairs Suspension HHS-OIG Terminated 6/15/2018 MI-Licensing Summary 7/2/2018 and Suspension 9/20/2018 Regulatory Terminated Kizy Wafid W. Dentist 1366564122 Oak Park 2901017596 1/18/2017 MDHHS-OIG 6/13/2019 Affairs Suspended Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason 3/18/87: Violation of Medicaid False Claim Act 12/16/86: Klein Alan Chiropractor Detroit 2301004270 3/18/1987 DCH 12/16/1986 HHS 1128(a)(1)
MI-Licensing and Regulatory Kleinert Kathleen M Physician 1336156231 Detroit 5101013318 11/24/2012 Affairs Knight Eugene Home Help Detroit 10/27/2016 MDHHS
MI-Licensing and Regulatory Voluntarily Knight James Physician Assistant 1831129949 Bay City 5601001002 12/7/2020 Affairs Surrendered Knight Keith Home Help Pontiac 3/22/2017 MDHHS Knott Orlando Home Help Muskegon 12/10/2018 MDHHS Knox Charles Ramon Home Help Detroit 11/30/2015 MDHHS Koffeman John Nicholas Chiropractor Ann Arbor 2301004912 12/19/1998 HHS 1128(b)(14) Kohli Jaspal S. Physician Warren 4301038647 8/3/1994 HHS 1128(a)(1) Kompus, Larry L., MD, PC Kompus Larry L. Physician Group Pontiac 4301026816 3/25/1991 HHS 1128(a)(1) Koop Rose Home Help Waterford 8/7/2015 DCH
MI-Licensing and Regulatory Voluntarily Korby Gordon Jay Physician 1801826953 Aubrun Hills 5101012577 6/7/2018 Affairs Surrendered
MI-Licensing and Regulatory Korstanje Raymond P Registered Nurse 1851525422 Grand Rapids 4704105538 1/7/2012 Affairs Suspended Summary Dixboro Village Pharmacy Kouza Raad Pharmacy 1093002115 Ann Arbor 12/22/2020 MDHHS-OIG Suspension Summary ER Drugs Kouza Raad Pharmacy 1871674366 Taylor 12/22/2020 MDHHS-OIG Suspension Summary Food Town Drugs Kouza Raad Pharmacy 1740299460 Monroe 12/22/2020 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Rockwood Pharmacy Kouza Raad Pharmacy 1609040062 Rockwood 12/22/2020 MDHHS-OIG Suspension Summary St. Paul Pharmacy Kouza Raad Pharmacy 1528326287 Detroit 12/22/2020 MDHHS-OIG Suspension Summary Dixboro Village Pharmacy Kouza Ramis Pharmacy 1093002115 Ann Arbor 12/22/2020 MDHHS-OIG Suspension Summary ER Drugs Kouza Ramis Pharmacy 1871674366 Taylor 12/22/2020 MDHHS-OIG Suspension Summary Food Town Drugs Kouza Ramis Pharmacy 1740299460 Monroe 12/22/2020 MDHHS-OIG Suspension Summary Rockwood Pharmacy Kouza Ramis Pharmacy 1609040062 Rockwood 12/22/2020 MDHHS-OIG Suspension Summary St. Paul Pharmacy Kouza Ramis Pharmacy 1528326287 Detroit 12/22/2020 MDHHS-OIG Suspension Kozlowski Karie Home Help Warren 2/5/2018 MDHHS Krempel's Pharmacy Krempel William Pharmacy Sault Ste. Marie 9/5/1985 HHS 1128(a)(1) 3/9/94: Vioilation of Medcaid False Claim Act 8/10/94: Kreuzer Dan Fredrick Physician 1053463646 Wayland 5101008291 3/9/1994 DCH 8/10/1994 HHS 1128(a)(1)
MI-Licensing and Regulatory Kreuzer Kevin Physician 1780722710 Grand Rapids 4301053795 4/18/2008 Affairs Suspended Kristoff Michael Home Help Allen Park 4/25/2016 MDHHS Krokker Rebecca Home Help Fort Gratiot 11/15/2018 MDHHS
MI-Licensing and Regulatory Summary Krol leslie A Counselor 1154652535 Swartz Creek 6401010535 4/23/2020 Affairs Suspension
MI-Licensing and Regulatory Summary Krupa Kyle Nurse 1003218496 Davison 4704255248 10/24/2019 Affairs Suspension Krusell Cheryl Home Help Rogers City 7/7/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Kucinski Richard C. Physician Utica 4301407406 9/1/2007 Affairs Suspended Summary Kufner Ronald Physician 1790764694 Big Rapids 4301079130 1/2/2019 MDHHS-OIG Suspension Kuhn Brian Home Help Clinton Township 1/21/2020 MDHHS Kuhn Virginia Home Help Detroit 5/12/2021 MDHHS Summary Suspension 5/20/2015 DCH-OIG Terminated Kuldanek Gregory A Physician 1568410496 Grand Rapids 4301047564 5/19/2015 DCH-OIG 10/19/2015 HHS-OIG Excluded Non-Emergency Kulp Robert Transportation Lake City 1/24/2019 MDHHS
MDHHS-OIG Summary MI-Licensing MI- Licensing Suspension and and Summary Regulatory 7/13/2016 Regulatory Suspension Kumar Vijay Physical Therapist 1730133117 West Branch 5501005559 7/24/2015 Affairs 02/10/2017 Affairs Revoked Kyles William Home Help Detroit 1/30/2020 MDHHS Terminated LaBarrie Sybil Home Help Hantramck 9/29/2016 MDHHS LaBeau Harold Home Help Hart 11/10/2020 MDHHS Ladaga Joseph H. Physician Dowagiac 5101009602 9/11/1996 HHS 1128(a)(2)
MI-Licensing and Regulatory Summary Lafata Philip J. Physician 1215037197 Caseville 4301023545 6/24/2008 Affairs Suspension Laframboise Jon Home Help Mount Morris 10/23/2014 DCH Lairy Saraya Home Help Detroit 9/8/2015 MDHHS Lambert Kandice Home Help Detroit 8/11/2015 MDHHS Non-Emergency Lamoreaux James Transportation Sault Sainte Marie 5/9/2017 MDHHS Landrum Corliss Home Help Detroit 11/16/2015 MDHHS Lane Cheryl Home Help Detroit 12/15/2015 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Summary Lane Robert E Physician 1972584159 Almont 5101004855 5/3/2017 Affairs 10/24/2017 Affairs Suspension Lang Germaine Home Help Muskegon 9/5/2018 MDHHS Lardell Nicole Home Help Pontiac 10/5/2015 MDHHS Summary Laster Pamela Home Help Saginaw 6/17/2020 MDHHS-OIG Suspension Lauchu Carlos M. Physician Saline 4301029754 3/16/1995 HHS 1128(b)(4) Lauderdale Selena Home Help Grand Rapids 5/27/2015 DCH
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Limited/ LaValley William J Social Worker 1912033051 Kalamazoo 6801084791 6/18/2019 Affairs 1/28/2020 Affairs restricted Lawrence Brian Home Help Warren 2/16/2017 MDHHS 12/17/97: 1128(b)(1) 1/4/84: East Side Pharmacy, Inc. Lazar Calvin R. Pharmacy Flint 12/17/1997 HHS 1/4/1984 1128(a)(1) Summary McNichols Drugstore Lazeki Rami Pharmacy 1073878625 Detroit 2/16/2021 MDHHS-OIG Suspension Leamon Yolanda G. Physician Battle Creek 4704106771 7/20/2000 HHS 1128(b)(4)
MI-Licensing and Regulatory Summary LeBaron Troy Optometrist 1124210091 Ada 4901004426 12/6/2019 Affairs Suspension Lee Antoine Home Help Saginaw 12/11/2018 MDHHS Lee Deion Home Help Saginaw 3/25/2019 MDHHS Lee Edith J. Physician Highland Park 4301022981 8/14/1986 HHS 1128(a)(1) Lee John Home Help Wyoming 11/29/2016 MDHHS Mandatory Lee Lessie Social Worker 1275948358 Flint 6801100508 3/19/2018 MDHHS Exclusion Summary Lee Sang H. Physician 1679790836 Detroit 4301032091 9/21/2011 DCH Suspension Pharmacy/Medical Cascade Pharmacy Leen Charles J. Supplier Grand Rapids 5301002313 5/8/1991 HHS 1128(b)(4) Heartside Pharmacy Leen Charles J. Pharmacy Grand Rapids 5301003879 5/8/1991 HHS 1128(b)(4) Leftridge Mozella Home Help Detroit 2/26/2020 MDHHS Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Leftwich Carl L. Dentist Detroit 2901007003 8/1/1990 HHS 1128(b)(4) Legault Thomas Home Help Roseville 1/18/2018 MDHHS Non-Emergency Legette Cassandra Transportation Detroit 8/15/2019 MDHHS Legette Danielle Home Help Ypsilanti 10/2/2019 MDHHS Legrand Jessica Home Help Warren 7/19/2018 MDHHS Summary Lehtinen John Physician Marquette 4301035115 3/15/2021 MDHHS-OIG Suspension Leitson Marcelino Joel Chiropractor Oak Park 2301005098 2/19/1998 HHS 1128(b)(1) Lenoir Renoir Home Help Detroit 5/15/2019 MDHHS
MI- Licensing and Summary Regulatory Suspension 06/27/2016 Affairs Revoked 7/20/2016 HHS-OIG Excluded Lerner Laran Physician 1598713430 Westland 5101008800 7/29/2015 MDHHS-OIG 3/29/2019 MDHHS-OIG Terminated Lesiewicz Alan Home Help Three Rivers 10/27/2020 MDHHS Lesley Jusy Home Help Kalamazoo 3/29/2016 MDHHS All American Medical Supplies, Summary Inc. Letko James Medical Supply Co. 1972744431 Venice, Florida 1/27/2021 MDHHS-OIG Suspension Lewis Andrew L Home Help Detroit 3/4/2015 DCH Summary Lewis David Physician 1548490709 Warren 4301088074 1/2/2019 MDHHS-OIG Suspension Lewis Dorothy Home Help Detroit 12/12/2016 MDHHS Lewis Freddie Home Help Detroit 11/26/2019 MDHHS Lewis Kevin Home Help Detroit 9/29/2015 MDHHS Lewis Maurice Home Help Lansing 11/30/2015 MDHHS Lewis Nefertari Home Help Pontiac 7/11/2018 MDHHS Lewis Pharen Home Help Detroit 9/6/2016 MDHHS Lewis Terrance Home Help Highland Park 11/3/2014 DCH Lieberman Ira Stephen Physician North Branch 8/20/2006 HHS 1128(a)(4) Lightfoot Arthur S. Physician Burton 4301023700 3/1/1990 HHS 1128(b)(4) Lile james Ho,e Help Detroit 10/8/2019 MDHHS Lilleberg Jessica Home Help Cadillac 7/7/2015 DCH Lilly Latoya Home Help Holt 11/30/2015 MDHHS Lim Billy Shee Dentist 1942356183 Detroit 2901015899 12/1/2007 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Affairs MI- Bureau of Licensing Suspended and Summary 09/20/2016 Regulatory Suspension 02/10/2017 Affairs Revoked 04/20/2017 HHS Excluded Linares Oscar A Physician 1689641458 Dearborn 4301045607 3/21/2013 DCH 11/13/18 MDHHS-OIG Terminated
MI-Licensing and Regulatory Lindeman Craig J Optometrist 1619024965 Lansing 4901002406 3/29/2012 Affairs Suspended Lindsey Tommy G. Chiropractor Mount Morris 2301002099 5/20/1998 HHS 1128(b)(4) Little Daniel Home Help Flint 2/9/2017 MDHHS
MI-Licensing and Regulatory Voluntarily Llovet Magalis Physician 1427066646 Grand Rapids 4301075353 1/16/2019 Affairs Surrendered
Lloyd Christopher Home Help Detroit 9/13/2016 MDHHS Lloyd Yolanda Home Help Detroit 8/1/2019 MDHHS Ritecare LLC Lobato Hans Group 1609035104 Livonia 1/19/2012 HHS 1128(b)f Ritecare LLC Lobato Hans Group 1508064775 Livonia 1/19/2012 HHS 1128(b)f Disciplinary Limited Lockwitz Todd A Physician 1861456071 Novi 4301054687 6/26/2018 MDHHS License Lofton Anthony Home Help Kalamazoo 12/27/2018 MDHHS Non-Emergency Lofton Don Transportation Adrian 1/2/2018 MDHHS Lofton George Home Help Saint Clair 4/22/2020 MDHHS Lofton-Jackson Levander Home Help Detroit 3/28/2019 MDHHS Londree Kim Home Help Iron Mountain 4/16/2018 MDHHS Long Lisa Home Help Kalamazoo 1/31/2018 MDHHS Long Tashema Home Help Detroit 11/30/2015 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Loomna Vivek Physician 1518277276 Troy 4301096034 3/15/2018 Affairs 8/1/2018 Affairs Revoked Looney Samuel Home Help Detroit 3/7/2017 MDHHS
MI-Licensing and Regulatory Loop William C. Physician 1710926944 East Tawas 4301042646 9/2/2009 Affairs Suspended Lootens Ray Home Help West Branch 10/31/2018 MDHHS Lopez Ernest Home Help Bay City 10/18/2016 MDHHS
MI-Licensing and Summary Regulatory Suspension Lotfi Ahad Chiropractor 1063420529 Hartford 2301006100 6/6/2017 MDHHS-OIG 3/1/2018 Affairs Revoked Lott Robert Home Help West Branch 4/25/2019 HHS-OIG Love Jarvon Home Help Detroit 8/7/2018 MDHHS Lowe Connie Home Help Beulah 12/5/2018 MDHHS Lowe Lawrence Home Help Detroit 6/25/2018 MDHHS
MI-Licensing and Regulatory Lowe Melody CRNA 1023026705 Sterling Heights 4704213505 2/6/2021 Affairs Suspended Lowe Raphael Home Help Inkster 2/22/2018 MDHHS Lowery Danny Home Help Detroit 9/11/2017 MDHHS Lucas William A. Physician Dearborn 4704127471 4/20/2000 HHS 1128(b)(4) Lucero Michelle Home Help Battle Creek 10/19/2015 MDHHS
MI-Licensing and Regulatory Suspended MI-Licensing Affairs MI- Disciplinary and Licensing and Limited Regulatory 11/29/2018 Regulatory Voluntarily Lugo--Medina Suzette Physician 1922025865 Coldwater 4301078982 11/18/2015 Affairs 06/19/2020 Affairs Surrendered Lundquist Jonathan Home Help Marquette 8/30/2019 MDHHS-OIG Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing Summary and and Suspension Regulatory regulatory Voluntarily Luoma David Physician 1245221076 Marquette 4301042739 2/27/2019 Affairs 9/18/2019 Affairs Surrendered Lusk Kenyatta Home Help Detroit 5/20/2019 MDHHS
MI-Licensing and Regulatory Lustre-Nosal Michelle CRNA 1083693113 Wolverine Lake 4704149936 9/1/2018 Affairs Suspended Lyman Winston Home Help Warren 5/6/2016 MDHHS Lynn Edward Home Help Idlewild 11/15/2016 MDHHS Lynn Jovon Home Help Saginaw 9/13/2016 MDHHS Non-Emergency Lyons Henry Transportation Westland 2/6/2019 MDHHS
MDHHS-OIG Summary MI-Licensing Suspension and Terminated 4/12/2018 Regulatory Voluntarily Maaz Bassam M Physician 1851314314 Dearborn 4301053885 12/1/2016 MDHHS-OIG 5/16/2018 Affairs Surrendered MacLean Charles A. Physician Owosso 4301025670 8/29/1995 HHS 1128(b)(4) Madden Torrnece Home Help Grand Rapids 11/12/2016 MDHHS Maddox Edward Home Help Detroit 3/26/2020 MDHHS Maddox Juanita Jean Home Help Detroit 3/16/2015 DCH
Controlled Substance License Only Summary Suspended Voluntariy Terminated MI-Licensing MI-Licensing Controlled and and Substance Regulatory Regulatory and Medical Madrid Ramon A Physician 1235176637 Farmington Hills 4301028439 7/19/2018 Affairs 9/19/2018 Affairs License Magee Elizabeth Home Help Carsonville 1/20/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Voluntarily Magid Larry Physician 1851382972 Milford 5901000741 1/23/2019 Affairs Surrendered
MI-Licensing and Regulatory Summary Mahabeer Howard Leslie Physician 1861449696 Reed City 4301048268 8/10/2017 Affairs Suspension
MI-Licensing and Regulatory Summary Main Justin L Nurse Practitoner 1295225506 Bay City 4704292433 7/29/2020 Affairs Suspension Emergency Summary Park Med Pharmacy Maki Auday Pharmacy 1396253696 Detroit 10/2/2020 MDHHS - OIG Suspension Makki Ali S. Physician 1114032414 Dearborn 4301048780 9/20/2011 HHS 1128(a)(1) Summary Lifecare Pharmacy of Michigan Makki Wansa Pharmacy 1306228721 Farmington Hills 5301010697 6/4/2019 MDHHS-OIG Suspension Lakeshore Spine & Pain PC Makwana Rajesh Group 1245260371 Ludington 2/22/2012 DCH Suspended
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Summary Malhotra Rajesh Physician 1891748547 Detroit 4301097855 9/8/2015 Affairs 6/30/2016 Affairs Suspension Malik Mukhtar Ahmad Physician Madison Heights 4301033579 9/2/1997 HHS 1128(b)(3) Malik Parveen Physician 1972668630 Bay City 4301065126 4/20/2010 HHS 1128(b)(7) Malone Deandre Home Help Harper Woods 6/20/2019 MDHHS Malone Kevin Louis Home Help Grand Rapids 12/1/2014 DCH 4/19/2018 MDHHS Mammo Waleed Dentist 1598939811 Sterling Heights 2901015678 4/10/2007 DCH Terminated Manigault Sean Home Help Highland Park 9/16/2020 MDHHS Mann Dejohn Home Help Grand Rapids 5/13/2015 DCH
MI-Licensing and Regulatory Manor James P. Nurse Anesthetist 1508912692 Wyandotte 4704136317 4/1/2014 Affairs Suspended Mansor Bassam Home Help Warren 7/20/2021 MDHHS Mape Avelino Marbella Physician Detroit 4301036423 9/23/1983 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Summary Marcano Carlos A. Physician 1639125040 Grand Rapids 4301057357 11/24/2008 Affairs Suspension Markowski Stephen Home Help Atlanta 10/13/2016 MDHHS Marnach Richard L Physician 1619923034 Minneapolis -MN 30333-MN 1/2/2013 HHS & DCH Suspended Marshall Aaron Home Help Detroit 4/7/2021 MDHHS Marshall Tanea Home Help Grand Rapids 11/17/2017 MDHHS Disciplinary Limited Martin Dana Physician 1215019963 Sturgis 5601002180 6/26/2018 MDHHS License Martin Daniel Home Help Detroit 5/5/2016 MDHHS Martin David Home Help Flint 9/3/2019 MDHHS Martin Dennis Home Help Detroit 12/14/2017 MDHHS Martin Fate Home Help Detroit 8/21/2018 MDHHS Martin Jessica Home Help Dearborn 11/26/2019 MDHHS Non-Emergency Martin Lenora Transportation Detroit 6/8/2017 MDHHS Martin Markeeta Home Help Detroit 12/5/2018 MDHHS Martin Robert Home Help Detroit 2/13/2018 MDHHS
MI-Licensing and Regulatory Martin Robert Physician 1861460420 Milford 5101007975 4/4/2019 Affairs Suspended Martin Terrell Home Help Detroit 6/5/2017 MDHHS Martin Michael Home Help Detroit 8/22/2017 MDHHS
MI-Licensing and Regulatory Martinez Jacob S. Physician 1124311014 Tecumseh 4301097527 8/23/2020 Affairs Suspended Martinez Joseph Home Help Ecorse 1/13/2016 MDHHS Martinez Martin M Home Help Grand Rapids 10/1/2015 MDHHS Mason Jamie Home Help Escanaba 11/21/2019 MDHHS Terminated
MI-Licensing and Regulatory Mason Marian Y Dentist 1295967438 Detroit 2901011681 8/1/2014 Affairs Suspended Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason MI-License Excluded and Summary 3/21/2018 Regulatory Suspension Mason Stephen B Physician 1528390259 Morgantown, WV 4301097993 2/20/2018 HHS-OIG 5/15/19 Affairs Suspended Mason William B Home Help Greenville 3/22/2021 MDHHS
MI-Licensing and Regulatory Revoked Affiars MI- Summary Licensing and Suspension 4/5/2016 Regulatory Summary 08/24/2016 Affairs Suspension 08/20/2017 HHS MDHHS-Excluded Masserant John C. Physician 1669454146 Monroe 4301076801 11/12/2015 MDHHS-OIG 09/20/2017 OIG Terminated Matthews Alice Home Help Flint 12/19/2016 MDHHS Matthews Deshaun Home Help Detroit 7/8/2019 MDHHS Matthewson Dawn Home Help Grand Rapids 10/14/2019 MDHHS Mauldin Brandon Home Help Detroit 4/12/2017 MDHHS Maury Nicholas Home Help Inkster 7/23/2019 MDHHS May Kathleen Home Help Luther 3/31/2015 DCH May Michael Home Help Grand Rapids 7/21/2020 MDHHS Parkside Mental Health, Inc. Mayberry Marie Victoria Physician Group Detroit 11/19/1998 HHS 1128(a)(1) Mayers Keith Home Help Vestaburg 1/29/2018 MDHHS
MI-Licensing and Regulartory Affairs Mi- MI-Licensing Licensing and amd Regulatory 9/21/2015 Regulatory Suspended Mayfield Stephanie Marie Physician 1740238286 Flint 4704167920 1/14/2009 Affairs 01/09/2016 Affairs Suspended Mayhue Terry Home Help Grand Rapids 2/17/2021 MDHHS Maynard Jamie Home Help Midland 6/21/2016 MDHHS Mays Sandra D Home Help Detroit 11/30/2015 MDHHS Summary Mays Thomas D MD PC Mays Thomas D. Medical Group 1508124082 Southfield 7/22/2019 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Voluntarily MI-Licensing MI-Licensing Surrendered and and Disciplinary Regulatory Regulatory Limited Mays Thomas D Physician 1255344339 Southfield 4301043030 9/16/2017 Affairs 11/20/2019 Affairs License Mazer Joel Allen Optometrist Flint 4901003693 9/20/2004 HHS 1128(a)(2) McCaskell Ruthie Home Help Detroit 3/10/2016 MDHHS McFarlin Helen Home Help Detroit 8/6/2020 MDHHS Mcabee Davies E Home Help Lansing 4/14/2015 DCH McAfee Eleazar Home Help Southfield 2/21/2019 MDHHS Non-Emergency Premier Non-Medical McBride Joshua Transportation Wyoming 1/16/2018 MDHHS McBride Ricky Home Help Garden City 10/18/2018 MDHHS McBride Stellana M Home Help Lansing 3/25/2015 DCH McCall Darnell Home Help Detroit 5/13/2016 MDHHS McCane Ariel Home Help Detroit 3/23/2017 MDHHS McCartney James R. Physician Bay City 4301041608 7/30/1986 HHS 1128(a)(1)
McCarver Williemendia Home Help Detroit 2/10/2016 MDHHS McCaster Kenneth Home Help Hazel Park 11/30/2015 MDHHS McClain Raymond Home Help Mendon 10/4/2017 MDHHS McClellan Devonte Home Help Detroit 5/2/2019 MDHHS McClinton Dalon Home Help Detroit 8/14/2019 MDHHS Terminated Limited McClure John Physician 1427091123 Saginaw 4301059267 8/30/2021 MDHHS License McConnal Catherine Home Help Detroit 7/24/2019 MDHHS McCovery Sherman Home Help Flint 4/21/2016 MDHHS McCoy Cedric Home Help Detroit 10/16/2015 MDHHS McCoy Michael Home Help Decatur 3/22/2021 MDHHS Samaritan Home Help LLC McCray Antonio Home Help Agency Eastpointe 3/3/2020 MDHHS-OIG Termintaed McCray Antonio Home Help Owner Harper Woods 3/3/2020 MDHHS-OIG Terminated McCray Marcus Home Help Saginaw 3/9/2017 MDHHS McCullum John Home Help Caro 4/11/2017 MDHHS McCurtis Dwayne Home Help Detroit 2/25/2020 MDHHS
McCutcheon Cambron Psychologist 1194020271 Kalamazoo 6301014896 8/8/2019 MDHHS- OIG Terminated McDermott Lamont M Home Help Lansing 12/17/2020 MDHHS McDonald Catrina Home Help Pontiac 12/7/2015 MDHHS McEwen Timothy Home Help Detroit 7/13/2017 MDHHS McFall Tracy Home Help South Haven 12/13/2018 MDHHS McFarland Nicholas Home Help Detroit 1/11/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing and and Summary McFarland- Regulatory Regulatory Suspension Reddick Jill Nurse Midwife 1780827261 Auburn 4704228799 5/24/2018 Affairs 11/3/2018 Affairs Suspended McFee Kiemar Home Help Detroit 11/21/2017 MDHHS McGaughy Asia Home Help Ann Arbor 1/25/2021 MDHHS McGee Leanon Home Help Detroit 1/9/2019 MDHHS McGlocton Theresa Home Help Center Line 2/4/2019 MDHHS McGowen- Summary Bienkowski Julia Counselor 1528581808 Clinotn Township 6401016197 4/20/2021 MDHHS-OIG Suspension McKinney Carolyn Home Help Muskegon 6/13/2016 MDHHS McKinney David W. Physician Detroit 4301031076 8/15/1990 HHS 1128(b)(4) McKinnie Linzell Home Help Wyoming 10/20/2014 DCH Towne Pharmacy McManaway Donald R. Pharmacy Monroe 5301001358 7/17/1985 HHS 1128(a)(1) McMillan Shawn Kurichan Home Help Burton 1/12/2015 DCH McMullen Scinicor Home Help Detroit 11/19/2015 MDHHS McNeil Melody Home Help Redford 7/26/2021 MDHHS McPhail William L. Physician Detroit 4301030183 7/30/1990 HHS 1128(a)(1) McRae Troy Home Help Detroit 3/16/2020 MDHHS
Summary Suspension Ban Mechael MD PC Mechael Ban Medical Group 1033301569 Livonia 9/17/2019 MDHHS-OIG 1/18/2021 MDHHS-OIG Termination
Summary Suspension Mechael Ban Physician 1124095666 Livonia 4301073200 9/17/2019 MDHHS-OIG 1/18/2021 MDHHS-OIG Termination Meeks Ricky Home Help Muskegon 2/18/2015 DCH Summary Access Care Home Care, Inc Mehood Zafar Home Health Agency 1134174006 Ypsilanti 5/22/2012 DCH Suspension Mejia-Garagorry Pedro Physician 1497919286 Grand Rapids 4301097908 4/15/2021 MDHHS Suspended Melchor Arthu Allen Home Help Adrian 2/24/2015 DCH Melton Bradley Home Help Detroit 11/6/2017 MDHHS
MI-Licensing and Regulatory Summary Melton Mark R. Physical Therapist 1861504425 Gaylord 5501009879 12/28/2007 Affairs Suspension Mendoza Samuel Physician Dearborn 4301020703 5/6/1997 HHS 1128(b)(4) Merkle Clifton Home Help White Pigeon 4/21/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Merlau Billie Home Help Syracuse 11/18/2019 MDHHS Merritt Edward Home Help Detroit 3/13/2018 MDHHS Merritt Michael Home Help Detroit 11/30/2015 MDHHS Summary Mesiwala Kutub H Physician 1548331705 Bloomington Hills 4301040545 3/11/2015 DCH-OIG Suspension Suspended 5/15/2015 DCH-OIG Terminated Messisco Joyce M Nurse Practitioner 1952505760 Macomb 4704164357 4/16/2015 DCH-OIG 08/20/2015 HHS Terminated Michael Tara Home Help Grand Rapids 12/13/2018 MDHHS 3/19/99: Violation of Medicaid False Claim Act 6/17/99: Michkovits, John F. PC Michkovits John F. Dental Group South Haven 2901008784 3/19/1999 DCH 6/17/1999 HHS 1128(a)(1) Mickel John Home Help Grand Rapids 11/21/2017 MDHHS Mickel Kenyatta Home Help Detroit 9/13/2016 MDHHS Middleton David H. Physician Ann Arbor 4301024480 7/1/1997 HHS 1128(b)(4)
Lakeland Convalescent Center Midenberg David S. Nursing Facility Detroit 83451 9/20/2000 HHS 1128(a)(2)
MI-Licensing and Regulatory Voluntarily Mihailoff Nevena M Physician 1740280569 Dearborn 4301039159 1/17/2018 Affairs Surrendered Pharmacy/Medical Fritz the Druggist Milder Joseph Supplier Muskegon Heights 5301000030 4/24/1986 HHS 1128(a)(1) Summary Miles Zekenia Home Help Grand Rapids 1/29/2014 DCH-OIG Suspension Summary Miller Angie Social Worker 1568400620 Sterling Heights 6801068386 8/7/2019 MDHHS-OIG Suspension Miller David Home Help Grand Rapids 2/20/2018 MDHHS
Miller Lloyd Livingston Physician Livonia 4301047699 2/9/1989 HHS 1128(b)(3)
MI-Licensing and Regulatory Miller Ross David Physician 1720086226 Hillsdale 4301056697 4/23/2010 Affairs Suspended Miller Theresa Home Help Dewitt 10/7/2015 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Miller Chrystal Home Help Alpena 8/3/2020 MDHHS Miller Joyce Home Help Madison Heghts 1/4/2016 MDHHS Non-Emergency Miller Stephen Transportation Alpena 3/16/2017 MDHHS Miller Steven Home Help Saginaw 3/22/2016 MDHHS
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Millette Michael P Physician Assistant 1043259591 McMillian 5601004986 9/29/2017 Affairs 7/17/2018 Affairs Revoked
MI-Licensing and Regulatory Voluntarily Millette Terrence Physician 1740298967 Pascagoula, MS 4301106498 9/19/2018 Affairs Surrenderd Summary DCH-OIG 3/8/2015 Summary Suspension Milliner Joel A Physician 1346438140 4301079083 6/19/2014 HHS 08/20/2015 Suspension Excluded Milton Deborah Denise Home Help Pontiac 6/10/2015 DCH Summary Miluk Paul R. Physician 1336139740 Niles 5101010370 9/18/2013 DCH Suspension Miral Leon R. Physician Detroit 5101005657 5/26/1988 HHS 1128(a)(1) Miskell Eric Home Help Musegon 1/12/2017 MDHHS Mitchell Chatondra Home Help Detroit 4/19/2018 MDHHS Mitchell Glenn E Home Help Redford 12/3/2020 MDHHS
Summary Suspension Mitchell Kenneth D Physician 1144390873 Southfield 5901001869 8/15/2018 MDHHS-OIG 9/14/2018 MDHHS-OIG Termination Mitchell Ladarin Q Home Help Detroit 11/12/2014 DCH Mitchell Marcella Home Help Detroit 7/8/2015 DCH
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Moffit Laura I. Registered Nurse 1669866984 Novi 4704301162 8/16/2018 Affairs 4/6/2019 Affairs Suspended
MI-Licensing and Regulatory Terminated Mohamed Abdullahi A Physician 1013009000 Alpena 4301084848 5/18/2013 Affairs 8/15/2013 DCH Suspended Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Mohiuddin Gulam Owner Hamtramck 4/9/2019 MDHHS-OIG Suspension Summary Suspension The Vein Center at Allure Medical Summary Spa Mok Charles Medical Group 1457302051 Shelby Township 5/11/2020 MDHHS-OIG 6/15/2020 MDHHS-OIG Suspension Summary Suspension Summary Mok Charles Physician 1235181876 Shelby Township 5101010912 5/11/2020 MDHHS-OIG 6/15/2020 MDHHS-OIG Suspension Molbrough David Home Help Detroit 6/14/2018 MDHHS Molett Reginald Home Help Pontiac 12/9/2015 MDHHS Monnan Syeed Home Help Warren 8/3/2017 MDHHS Monroe Frederick Home Help Benton Harbor 4/25/2018 MDHHS
MI-Licensing and Regulatory Summary Monteleone Melissa M. Nurse 1861439184 Huntington Woods 4704160940 11/8/2010 Affairs Suspension Non-Emergency Montgomery Lisa Transportation Mio 5/31/2017 MDHHS Moody Carthan Lagrant Dentist Kalamazoo 2901014263 1/20/2004 HHS 1128(a)(1) Moore Alisha Marie Home Help Warren 4/7/2015 DCH Moore Allen Home Help Saginaw 3/14/2016 MDHHS Moore Dannetta Marie Home Help Benton Harbor 6/10/2015 DCH Summary Suspension Healthy Hearts Moore Kamitko Group 1093908436 Livonia 7/25/2016 MDHHS-OIG 3/29/2019 MDHHS-OIG Terminated Summary New Beginning Adult Senior Care Suspension Center Moore Kamitko Group 1124431580 Livonia 7/25/2016 MDHHS-OIG 3/29/2019 MDHHS-OIG Terminated Moore Kamitko Home Help Taylor 8/31/2017 HHS-OIG Moore Kimberly Home Help Detoit 9/28/2020 MDHHS Moore Ladonna Home Help Detroit 1/9/2019 MDHHS Moore Terrell Home Help Kalamazoo 7/6/2020 MDHHS Moore Thelma Home Help Lansing 5/18/2021 MDHHS
Moore Timothy Home Help Detroit 10/13/2014 DCH
Morejon Maribel Home Help etroit 7/16/2021 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Oak Park Madison Summary Moret-Quezada Rodney Physician 1851451819 Heights 4301064420 12/22/2015 DCH-HHS 3/31/2017 HHS Suspension Morgan Hollis Home Help Benton Harbor 8/23/2016 MDHHS
MI-Licensing and Regulatory Summary Moroschan Joseph E Physician 1760482608 Fort Worth 4301113656 7/20/2020 Affairs Suspension Morrell Javonda Home Help Lansing 6/17/2015 DCH Morris Dawayne Home Help Detroit 6/24/2020 MDHHS Morris Jacqueline Home Help Kalkaska 4/5/2016 MDHHS Morrison Amy Home Help Rapid City 12/12/2018 MDHHS Moser carrie Home Help Davison 6/28/2017 MDHHS
MI-Licensing and Regulatory Mosimbwa Charles Andrew Physician 1215134408 Berrien Springs 4301089193 3/12/2012 Affairs Suspended Mosley Chiante Home Help Westland 2/7/2019 MDHHS Summary Mosley Mfed Physician 1215403597 Dearborn 4301077255 4/19/2021 MDHHS- OIG Suspension Moss David Home Help Benton Harbor 7/26/2021 MDHHS Moss Latonya Home Help Detroit 12/4/2014 DCH Moss Mitchell Home Help Detroit 6/25/2015 DCH Mull Reta Home Help Fremont 3/11/2019 MDHHS
MI-Licensing and Regulatory Summary Mullens Thomas Social Worker 1801978903 Holland 6801089541 8/5/2020 Affairs Suspended Munn Karl Home Help Kalamazoo 5/9/2016 MDHHS Munshey Munir Ahmed Physician Ypsilanti 4301032297 9/11/1996 HHS 1128(a)(1)
MI-Licensing and Regulatory Murphy Rosanne Physician 1245308790 Detroit 4301050350 7/30/2013 Affairs Suspended Murray Dwayne Home Help Lansing 2/20/2015 DCH Murrie Tommie Home Help Detroit 3/15/2017 MDHHS Murtuza Atiya Physician Centerline 4301042165 4/12/1993 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
Summary Suspension and Myers Crystal Home Help Detroit 7/22/2015 MDHHS-OIG Termination Myers Robert Home Help Mattawan 1/23/2019 MDHHS Summary Suspension Summary Mynes Brandon Home Help Adrian 7/17/2019 MDHHS-OIG 4/13/2021 MDHHS-OIG Suspension
MI-Licensing and Regulatory Mynt Toe Physician 1982618138 Madison Heights 4301084986 7/9/2010 Affairs Suspended
Summary Suspension Care for You Pharmacy Naeem Rana Pharmacy 1073743282 Detroit NCPDP 2373114 8/23/2011 DCH 7/11/2016 MDHHS-OIG Termination Summary Suspension Preferred Care Pharmacy Naeem Rana Pharmacy 1467787770 Pontiac NCPDP 2373328 8/23/2011 DCH 5/25/2016 MDHHS-OIG Terminated Summary Suspension Taylor Apothecary Naeem Rana Pharmacy 1801026158 Taylor NCPDP 2373126 8/23/2011 DCH 5/30/2016 MDHHS-OIG Terminated Summary Nagarwala Jumana Physician 1619048329 Detroit 431071795 9/19/2017 MDHHS-OIG Suspension
MI-Licensing and Regulatory Voluntarily Nagy Laurence W Dentist 1093910911 Canton 2901009367 8/9/2012 Affairs Surrendered Nakhle Janet Home Help Dearborn 5/31/2018 HHS-OIG 2/3/94: Violation of Medicaid False Claim Act 8/10/94: Nali Frank Physician Warren 4301047701 2/3/1994 DCH 8/10/1994 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
DCH Summary MI- Licensing Suspension and Temination 3/6/2013 Regulatory Summary 01/24/2017 Affairs Suspension Nallani Surya C. Physician 1801838651 Birmingham 4301073842 3/6/2013 DCH-OIG 10/29/2018 MDHHS-OIG Terminated Namy Jonathan Home Help West Bloomfield 10/19/2016 MDHHS
MI-Licensing and Regulatory Voluntarily Nandamudu Deepali Social Work 1316361967 Fort Gratiot 6801068852 10/11/2019 Affairs Surrendered Napier Luther Home Help East Pointe 1/19/2016 MDHHS Napier Tyrone Home Help Detroit 7/6/2015 DCH Nash Elliott Home Help Kalamazoo 12/10/2014 DCH Nash Johnathan l Home Help Detroit 4/27/2015 DCH
Mi-Licensing and Regulatory Revoked Affairs MI Suspended 04/25/2017 Licensing and Suspended 1/24/2017 Regulatory Excluded 07/19/2017 Affairs HHS- Terminated 4/20/18 OIG MDHHS- Excluded 5/20/18 OIG HHS-OIG Permanently Nassar Lawrence Physician 1912011594 East Lansing 5101012213 2/7/2017 MDHHS-OIG 4/5/18 MI-LARA Revoked Nasser Omar Home Help Sterling Heights 8/23/2016 MDHHS Navyac Debbie Home Help Madison Heights 6/13/2016 MDHHS Neal Robert Home Help Detroit 1/10/2017 MDHHS Neal Shamonte Home Help Flint 10/30/2019 MDHHS Neal Tiffany Home Help Lansing 7/25/2017 MDHHS Neal Vernell Home Help Detroit 3/17/2021 MDHHS Summary Neale Jerry Social Worker 1750921318 Flint 6801097494 5/20/2020 MDHHS-OIG Suspension Nealy Stephen Lamar Home Help Eastpointe 11/30/2015 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Bella Rose Rehabilitation & Aquatic Services LLC Nederhood Esther Group 1568741767 Lake City 7/13/2019 MDHHS Terminated Neeley Phillip Home Help Detroit 1/25/2017 MDHHS
DCH Summary MI- Licensing Suspension and Terminated 10/18/2013 Regulatory Summary Neely Richard Physician 1013908797 Durand 5101004783 9/18/2013 DCH 02/23/2017 Affairs Suspension Neely Takshia Home Help Detroit 11/26/2018 MDHHS
Voluntarily Surrendered MI-Licensing Summary and Suspended 6/6/2017 Regulatory Voluntarily Nelson Barbara G. Physician 1700981040 Eastpointe 4301041753 5/22/2013 OTHER STATE 5/16/18 affairs Surrendered Nelson Deacon Home Help Sault Ste. Marie 2/17/2021 MDHHS Nelson Patrick Home Help detroit 5/24/2016 MDHHS Nelson Roger Wayne Chiropractor Pontiac 2301006600 10/10/1995 HHS 1128(b)(14) Nelson Ronnie Home Help Kalamazoo 5/5/2016 MDHHS Nelson Tekeshon Home Help Grand Rapids 2/2/2016 MDHHS
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Reegulatory Volunmtarily Neri, Jr. Jesus C. Physician 1730109539 Rogers City 4301045742 4/4/2016 Affairs 5/18/2016 Affairs Surrendered Nesbitt Gregory Home Help Oak Park 11/14/2017 MDHHS
MI-Licensing and Regulatory Summary Nesbitt Renee Private Duty Nurse 1588147409 Waterford 4704337833 2/10/2020 Affairs Suspension
MI-Licensing MI-Licensing and and Regulatory Regulatory Suspended Neumeier Thomas C. Dentist 1619918687 Menominee 2901008867 7/10/2016 Affairs 6/9/2018 Affairs Revoked Neves Ekra Home Help Detroit 11/10/2014 DCH Newbury Harvey Home Help Three Rivers 7/12/2021 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Newcombe Arthur Home Help Lansing 6/4/2019 MDHHS Newton Jermaine Home Help Detroit 6/10/2015 DCH Nichols Christian Home Help Flint 5/16/2019 MDHHS Nichols Rachel A Home Help Owosso 5/19/2015 DCH
MI-Licensing and Regulatory Voluntarily Nicholson III Robert M. Physician 1447225347 Kalmazoo 4301046860 1/17/2018 Affairs Surrendered Nicklosovich James Home Help Charlotte 6/20/2018 MDHHS Nikodem Heith Home Help Niles 11/14/2018 MDHHS Nix Edna Home Help Detroit 11/17/2016 MDHHS Nordman Ashley Home Help Lansing 12/13/2018 MDHHS Norman Joseph Home Help Auburn Hills 1/14/2017 MDHHS Norman Willie Home Help Detroit 12/15/2020 MDHHS Norman Eric Home Help Detroit 1/10/2018 MDHHS Nosal Leonard Dentist 1427254069 White Lake 2901011174 7/20/2004 HHS 1128(a)(4) Notley Jammie L Home Help White Cloud 11/5/2014 DCH Nwankwo Portia Home Help Detroitq 5/17/2017 MDHHS
MI-Licensing and Regulatory Nydorf Ethan Physician 1174601207 West Bloomfield 4301064988 1/16/2019 Affairs Suspended
MI-Licensing and Regulatory Summary Obert Amy B. Registered Nurse 1427371210 Grand Rapids 4704236200 10/7/2011 Affairs Suspension Odinma Moses Home Help Detroit 11/19/2016 MDHHS Odle Richard Home Help Ithaca 2/12/2015 DCH
MI-Licensing and Suspended Regulatory Summary MI-Licensing 2/13/2017 Affairs Suspension and 01/17/2018 MDHHS-OIG Suspension Regulatory 8/31/2018 MDHHS-OIG Terminated Oesterling Joseph E Physician 1538136353 Saginaw 4301063677 12/9/2016 Affairs 02/20/2020 HHS-OIG Excluded Ojeda Angela Home Help Southfield 8/2/2017 MDHHS Oldham Ira Home Help Detroit 12/26/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Oliver Ashley L Home Help Lansing 11/26/2014 DCH Oliver Eric E Home Help Detroit 11/30/2015 MDHHS
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Olson Alicia Physician 1669603171 Kirkland 4301095224 10/29/2018 Affairs 2/15/2019 Affairs Suspended Olson Julie Home Help Bangor 10/13/2017 MDHHS O'Neil Edward Home Help Harrison 1/9/2017 MDHHS Ong George Hansing Physician Kalamazoo 4301030442 12/12/1995 HHS 1128(a)(1)
MI-Licensing and Summary Regulatory Suspension Oniango Tete Physician 1629267133 Dearborn 4301091134 9/5/2018 MDHHS-OIG 6/13/2019 Affairs Revoked
MI-Licensing Suspended and 12/5/2016 MDHHS-OIG Suspended Regulatory 02/09/2017 MDHHS-OIG Terminated Ononuju Chidozie J Physician 1316984750 Saginaw 5101013295 11/2/2016 Affairs 08/20/2017 HHS Excluded Summary Onuoha Kenneth Physician 1902114424 East Lansing 5101019040 6/11/2019 MDHHS-OIG Suspension Orzame & Orzame, MD, PLLC Orzame Gabriel Sagun Physician Group Watervlite 4301044937 8/20/1998 HHS 1128(a)(1) Osher Francis M. Physician Birch Run 5101005370 6/29/1992 HHS 1128(b)(3) Suspended 6/29/2017 MDHHS-OIG Terminated Osterhout Ann Home Help Bay City 7/18/2016 MDHHS-OIG 9/29/17 HHS-OIG Excluded Ostrand Mary Home Help Snover 2/8/2018 MDHHS Ouro Noor Home Help West Bloomfield 12/11/2019 MDHHS Owdish William Home Help Oak Park 8/13/2018 MDHHS-OIG Owens Cornelius Home Help Saginaw 10/31/2017 MDHHS Owens Kristina Home Help Detroit 2/10/2016 MDHHS Paige Tommy Darnell Home Help Grand Rapids 7/15/2021 MDHHS Palmer Kathy Home Help Saginaw 6/27/2017 MDHHS Suspended 6/20/2018 HHS-OIG Exluded Pamatmat Adelfo N Physician 1285676734 Detroit 4301034892 7/30/2013 DCH-OIG 11/13/18 MDHHS-OIG Terminated Pannell Larjuan Home Help Detroit 1/17/2017 MDHHS Pannell Robin Home Help Detroit 1/8/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Pannu Baljinder S Physician 1518011451 Oak Park 4301066542 9/5/2012 Affairs Suspended
MDHHS-OIG MI-Licensing and Summary Regulatory Suspension Affairs MI- Terminated 3/28/2019 Licensing and Summary 5/03/2019 Regulatory Suspension Papachristou Marios Radiologist 1366765323 Detroit 4301109449 6/25/2018 MDHHS-OIG 10/01/2019 Affairs Revoked Summary Pappas Spilios Physician 1649202250 Detroit 4301052677 11/12/2017 MDHHS-OIG Suspension Pappas William John Home Help Madison Heights 12/23/2014 DCH Paquette Andre Home Help Millington 3/2/2020 MDHHS Paris Rashaan Home Help Detroit 4/18/2017 MDHHS
MI-Licensing and Regulatory Criminal Park James Physician 1144258971 Owosso 4301024053 8/4/2010 Affairs Conviction Parker Amanda Home Help Detroit 3/29/2016 MDHHS Parker Antoine Home Help Detroit 10/29/2016 MDHHS Parker Johnnie Home Help Pontiac 1/18/2018 MDHHS Parkhurst Laura Home Help Carrolton 4/26/2015 MDHHS Parks Joe Home Help Flint 2/25/2019 MDHHS Parrett Sarah Home Help Kalamazoo 8/11/2015 MDHHS Partridge Darrell Home Help Detroit 11/27/2018 MDHHS Summary Suspension 1/9/2017 MDHHS-OIG Terminated Patel Arvind Physician 1437217601 Detroit 4301034282 7/4/2016 MDHHS-OIG 04/20/2017 HHS Excluded
Summary Baba/Jyotsn Suspension Levan Pharmacy Patel a Pharmacy 1861513194 Grand Blanc NCPDP 2367781 8/19/2011 DCH 7/11/2016 MDHHS-OIG Termination Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Caring Pharmacy Patel Jyotsna Pharmacy 1407861347 Detroit NCPDP 2368202 8/19/2011 DCH Suspension
Summary Suspension Detroit Care Pharmacy Patel Jyotsna Pharmacy 1295908069 Detroit NCPDP 2371019 8/19/2011 DCH 7/11/2016 MDHHS-OIG Termination Summary Suspension Prestige Drugs Patel Jyotsna Pharmacy 1174787766 Hazel Park NCPDP 2371590 8/19/2011 DCH 5/30/2016 MDHHS-OIG Terminated Summary Rapid Pharmacy Patel Jyotsna Pharmacy 1871625004 Warren NCPDP 2369494 8/19/2011 DCH Suspension Kamuben/Jy Summary Eastpoint Pharmacy Patel otsnaben Pharmacy 1760643076 Roseville NCPDP 2371336 8/19/2011 DCH Suspension Summary Bestcare Pharmacy Patel Kiran Pharmacy 1114124260 Warren NCPDP 2369898 8/23/2011 DCH Suspension Summary Rapid Drugs Patel Kiran Pharmacy 1063605954 Southfield NCPDP 2370271 8/23/2011 DCH Suspension 7/15/87: Violationf of Medicaid False Claim Act 12/23/91: Patel Rameshbhai F. Physician Huntington Woods 4301036995 7/15/1987 DCH 12/23/1991 HHS 1128(a)(1)
MI-Licensing and Regulatory Summary Patel Rohane Avind Physician 1114049343 Rochester Hills 4301052678 11/21/2008 Affairs Suspension 5/21/99: Violation of Medicaid False Claim Act Sharadchand 6/17/99: Patel ra D. Physician Saginaw 4301033216 5/21/1999 DCH 6/17/1999 HHS 1128(a)(1) Summary Suspension Rx Now Pharmacy Patel Vijay Pharmacy 1619297553 Livonia NCPDP 2374116 8/19/2011 DCH 6/2/2016 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
Summary Suspension Tri-City Apothecary Patel Vijay Pharmacy 1144554106 Saginaw NCPDP 2373265 8/19/2011 DCH 5/23/2016 MDHHS-OIG Termination
Summary Suspension Responsible Care Pharmacy Patel Virabhai Pharmacy 1861668089 Detroit NCPDP 2371160 8/19/2011 DCH 5/23/2016 MDHHS-OIG Termination Francisco Summary FDRS Diagnostics PLLC Patino (Frank) Medical Group 1962837815 Livonia 8/8/2018 MDHHS-OIG Suspension Francisco Summary Patino Laboratories LLC Patino (Frank) Laboratory 1235520313 Livonia 8/8/2018 MDHHS-OIG Suspension Renaissance Age Management Francisco Summary Institute LLC Patino (Frank) Medical Group 1285895912 Livonia 8/8/2018 MDHHS-OIG Suspension Francisco Summary Patino (Frank) Physician 1538147723 Livonia 4301051672 8/8/2018 MDHHS-OIG Suspension Patman Darnell Home Help Saginaw 7/31/2019 MDHHS Patrick Mark Home Help Detroit 4/11/2016 MDHHS Patrick Michelle Home Help Detroit 10/21/2015 MDHHS Patterson Andre Home Help Detroit 7/21/2016 MDHHS Patterson Steve Home Help Hastings 6/29/2017 MDHHS
MI-Licensing and Regulatory License Paupore Joseph Thomas Physician 1841285467 Livonia 5101012057 4/21/2008 Affairs Revocation
MI-Licensing and Regulatory Payea Richard Paul Physician 1124019674 East Tawas 4301047848 9/2/2009 Affairs Suspended Payne Laron Home Help Battle Creek 3/23/2017 MDHHS Payne Ulie Home Help Lansing 12/23/2014 DCH Payton Christopher Home Help Detroit 12/20/2017 MDHHS Pear Michael Home Help Sterling 5/17/2018 MDHHS
MI-Licensing and Regulatory Summary Pearce Edwin T. Physician 1114977618 Clinton Township 4301021837 10/7/2008 Affairs Suspension Pearson Sarah Home Help Grand Rapids 7/14/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Peek Aaron Home Help Westland 3/6/2019 MDHHS-OIG Suspension Peeples- Jones Angela Home Help Westland 9/26/2017 MDHHS Peneger Kevin Home Help Flint 4/18/2016 MDHHS Pennell Alan Home Help Idlewild 11/30/2015 MDHHS Peoples Leonora Home Help Detroit 9/18/2015 MDHHS Peoples Terence Home Help Wayne 4/8/2020 MDHHS Perez Gilberto Home Help Grand Rapids 2/23/2017 MDHHS
Perkins Kim Home Help Port Huron 10/25/2016 MDHHS
Perkins Margaret Home Help Grand Ledge 11/20/2019 MDHHS- OIG Terminated Perkins Yvette Home Help Detroit 4/12/2018 MDHHS Peterson Dwight Home Help Highland Park 9/21/2017 MDHHS Petipren David J. Dentist Capac 2901008794 6/13/1990 HHS 1128(b)(4)
MI-Licensing and Regulatory Affairs Summary MDHHS-OIG Suspension MI- Licesning Summary 2/15/2015 and Suspension 12/29/2015 regulatory Termination Petre Paul M. Physician 1023145232 Warren 4301078751 9/26/2011 DCH 07/20/2016 Affairs Revoked Petroelje Glenn E. Dentist Holland 2901007127 7/28/1986 HHS 1128(a)(1) Pettes Jalen Home Help Flint 8/6/2019 MDHHS Pfeifer Lauren Joan Physician Caro 4301056619 5/20/2004 HHS 1128(b)(4) Philip Pinkie Home Help Detroit 11/30/2017 HHS-OIG Phillips David Chaffee Physician Allegan 4301046887 3/20/2003 HHS 1128(b)(4) Phillips Jonathan Home Help Grand Rapids 10/13/2014 DCH Phinn Leamon Home Help Detroit 12/19/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Suspension Piazza Richard Physician 1598914194 Stanton 5101018019 6/11/2019 MDHHS-OIG 3/26/2021 MDHHS-OIG Terminated
MI-Licensing and Suspended Regulatory Summary Pickens Jr Alex Physician 1649226507 Detroit 4301038348 3/12/2017 Affairs 8/23/2017 MDHHS-OIG Suspension Non-Emergency Pickett Laron Transportation Detroit 5/13/2019 MDHHS Pickett Shirley Home Help Dearborn Heights 5/6/2020 MDHHS
MI-Licensing and Regulatory Piechocki Joseph J Physical Therapist 1548370034 Macomb Twp 5501004900 5/27/2017 Affairs Suspended Pierce Darrin Home Help Roseville 8/23/2018 MDHHS
Suspension and Pilot Loretta Home Help Detroit 6/15/2015 DCH-OIG Termination Pinkard Jean Nurse Practitioner 1972970838 Farmington Hills 4704164057 8/3/2020 MDHHS-OIG Suspended Pinkins Deandre Home Help Detroit 12/21/2016 MDHHS Pinkston Jamol Home Help Saginaw 11/29/2018 MDHHS Pittman Antonio Home Help Lansing 10/20/2016 MDHHS
MI-Licensing and Regulatory Pittman Venise Jamison Physician 1720037260 Westland 4704145670 2/20/2009 Affairs Suspended Pitts Joseph A. Physician Detroit 5101006636 10/18/2001 HHS 1128(b)(15) Pitts Mark Home Help Detroit 7/17/2017 MDHHS Summary Pitts Timperance Home Help Ionia 5/22/2020 MDHHS-OIG Suspension Pleasants Maurice Home Help Detroit 4/6/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason 9/13/02: Violation of Medicaid False Claim Act 1/20/03: Plucer, Mark G., DO, PC Plucer Mark G. Physician Group Flint 5101006481 9/13/2002 DCH 1/20/2003 HHS 1128(a)(1) Polk Alphonozo Home Help Flint 2/13/2017 MDHHS Summary Tri-Cities Care LLC Pollard Tina Home Help Agency Saginaw 7/22/2019 MDHHS-OIG Suspension Interventional Pain Management Summary Associates PC Pompy Lesly Medical Group 1538113964 Monroe 8/6/2018 MDHHS-OIG Suspension
MI-Licensing and Regulatory Summary Pompy Lesly Physician 1174578801 Monroe 4301058720 8/4/2017 Affairs Suspension
MI-Licensing and Regulatory License Ponce Fernando Chiropractor 1669681508 Lansing 2301005828 5/28/2008 Affairs Revocation Poole Portia Home Help Detroit 3/29/2016 MDHHS Poole Richard Home Help Jackson 10/30/2018 MDHHS
Excluded Termination Summary 10/20/2016 HHS-OIG Suspension Poonpanij Sonjai Physician 1891895462 Southfield 4301032562 3/6/2013 DCH 8/9/2016 MDHHS-OIG Termination Sethavarang Summary Pornpichit ura Physician Detroit 4301033113 9/27/2007 DCH Suspension Porter Alexis Home Help Detroit 2/9/2017 MDHHS Porter Leroy Home Help Detroit 11/30/2015 MDHHS Porter James Home Help Battle Creek 7/20/2017 MDHHS Harbor Medical Diagnostic Clinic, Inc. Povlitz Robert H. Physician Group Keego Harbor 4/11/1991 HHS 1128(a)(1) Powell Jerry Home Help Westland 8/2/2018 MDHHS Powell Kimani home Help inkster 6/4/2020 MDHHS Powell Robert Home Help Clinton Township 9/19/2017 MDHHS Powell Shane Home Help Royal Oak 10/30/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Powers Jermaine Home Help Southfield 12/11/2018 MDHHS
MI-Licensing and Regulatory Voluntarily Prais Maureen CRNA 1497792717 Manchester 4704102142 6/1/2016 Affairs Surrendered Premeau John Home Help Marquette 8/2/2017 MDHHS Price Calvin U. Physician Flint 5101004559 7/22/1991 HHS 1128(a)(1)
Excluded Price Jacklyn Home Help Shelby Township 6/20/2019 HHS-OIG 9/30/2019 MDHHS-OIG Termination Price Tony Home Help Detroit 2/20/2015 DCH Non-Emergency Pritchet-Hill Brenda Transportation Wayne 12/27/2018 MDHHS Mandatory Pritchett Steven Social Worker 1083002471 Redord 6801101345 5/24/2018 MDHHS 6/12/2018 MDHHS Exclusion Proby Keith Home Help Muskegon 4/28/2015 DCH
MI-Licensing and Rgulatory Disiciplinary MI-Licensing Affairs MI- Limited and Licensing and License Regulatory 2/27/2020 Regulatory Suspended Proctor Vernon E Physician 1225215783 Baldwin 4301089365 12/30/2017 Affairs 07/02/2020 Affair Suspended Pruitt Marcel Home Help Detroit 3/7/2016 MDHHS Pryor Lawrence Home Help Jackson 7/31/2019 MDHHS Puente Karen A Home Help Melvindale 1/26/2015 DCH Pugh Dylan Home Help Detroit 2/6/2019 MDHHS Pugh Henry Home Help Detroit 7/21/2016 MDHHS Pugh timothy Home Help Burr Oak 5/3/2017 MDHHS Pullen Kenneth Home Help Detroit 12/18/2014 DCH Pullian Yuolanda E Home Help Benton Harbor 12/5/2014 DCH Purnell Linda Home Help Mount Morris 12/14/2015 MDHHS Non-Emergency Putman Courtney Transportation Southfield 11/29/2018 MDHHS Detroit Plaza II Pharmacy Pylar George Pharmacy Detroit 5301003640 6/8/1988 HHS 1128(b)(3) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI- Licensing and Summary Regulatory Suspension Affairs MI- Summary Licensing and Suspension 4/20/2016 Regulatory Summary Qadir Rizwan Physician 1427136043 Sterling Heights 4301062248 7/29/2015 MDHHS-OIG 10/05/2017 Affairs Suspension
DCH-OIG DCH-OIG Suspended & MI-Licensing MI-Licensing Summary and 5/21/2013 and Suspension Regulatory 06/19/2014 Regulatory Termination Qandil Basil A Physician 1720288749 Hamtramck 4301087756 1/22/2013 Affairs 10/08/2015 affairs Revoked
MI-Licensing and Regulatory Quinlan James T Physician 1730272592 Traverse City 4301093587 11/5/2012 Affairs Suspended
MI-Licensing and Regulatory Summary Quinn Brian Patrick Physician 1104028828 Royal Oak 4704234655 6/18/2009 Affairs Suspension
MI-Licensing MI- Licensing and and Regulatory Regulatory Suspended Quinn Donald R. Dentist 1417102492 Farmington Hills 2901013192 11/9/2014 Affairs 3/4/2015 Affairs Revoked Quinn Eric Home Help River Rouge 10/27/2020 MDHHS Pharmacy/Medical Inkster Community Pharmacy Quisenberry Charles P. Supplier Inkster 10/20/1998 HHS 1128(a)(1) Pharmacy/Medical Southfield Family Pharmacy Quisenberry Charles P. Supplier Southfield 5301003940 10/20/1998 HHS 1128(a)(1) 10/20/98: 1128(a)(1) Pharmacy/Medical 11/14/95: Weisel Drug Company Quisenberry Charles P. Supplier Monroe 10/20/1998 HHS 11/14/1995 HHS 1128(a)(1) Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Weisel Newport Pharmacy Quisenberry Charles P. Pharmacy New Port 5301004763 10/20/1998 HHS 1128(a)(1) Weisel Pharmacy, Inc. (aka Cross Drug Store) Quisenberry Charles P. Pharmacy Menomiee 5301004621 10/20/1998 HHS 1128(a)(1)
MDHHS-OIG HHS-OIG MI- Licensing and Summary Regulatory Suspension Affairs Terminated 8/31/2018 MI-Licensing Terminated 9/20/2018 and Summary 10/23/2018 regulatory Suspension Quizon Roberto G Physician 1538237482 Detroit 4301033614 6/14/2016 MDHHS-OIG 01/28/2020 Affairs Revoked 6/13/01: Violation of Medicaid False Claim Act 10/18/01: Racette, Wendell A. DDS, PC Racette Wendell A. Dental Group Lansing 2901010020 6/13/2001 DCH HHS 1128(a)(1) Rademacher Thomas Home Help Middleton 3/16/2021 MDHHS
MI-Licensing and Regulatory Rae Lauralee Social Worker 1407155534 Grand Rapids 6801089086 3/31/2020 Affairs Raheem Ahmad Home Help Grand Rapids 2/25/2021 MDHHS Raheem Ali Home Help Wayne 3/19/2020 MDHHS Summary Associated Physicians of Suspension Southeast Michigan P.C. Rahim Mahmoud Group 1336240951 Dearborn 8/3/2016 MDHHS-OIG 10/30/2018 MDHHS-OIG Terminated Summary Suspension Dearborn Internist P.C. Rahim Mahmoud Medical Group 1023314341 Dearborn 3/14/2017 MDHHS-OIG 10/30/2018 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Suspension Summary Suspension MI-Licensing Summary and Suspension 4/23/2018 Regulatory Disolved 8/1/2018 Affairs Revoked 10/30/2018 MDHHS-OIG Terminated Rahim Mahmoud Physician 1982706941 Dearborn 4301065143 8/3/2016 MDHHS-OIG 6/20/2019 HHS-OIG Excluded Physicians Choice Home Health Summary Care LLC Rahman Tausif Home Health Agency 1578689386 Livonia 237636 5/29/2012 DCH Suspension Non-Emergency Raines Jason Transportation Detroit 1/4/2018 MDHHS Rainey James Home Help Grand Rapids 3/19/2019 MDHHS Rainwater Jesse Home Help Detroit 9/9/2019 MDHHS
MI-Licensing and Regulatory Voluntarily Rama Kumara Physician 1487641148 Grosse Pointe 4301040250 5/19/2021 Affairs Surrendered Ramadan Ogus K. Physician Grand Blanc 4301030567 7/12/1992 HHS 1128(a)(1)
MI-Licensing and Regulatory Voluntarily Rambo Joseph Jean Physician 1447242789 Bridgman 4301023443 10/16/2015 Affairs Surrendered Ramirez Maria Home Help Wyoming 8/20/2020 HHS-OIG Suspended
Rams Christopher Nurse Practitioner 1710249057 Flint 4704203621 8/16/2020 MDHHS Terminated Ramsey Moriba Home Help Detroit 2/6/2017 MDHHS Summary Rasool Kashif Physician 1629287461 Detroit 4301083619 12/18/2017 MDHHS-OIG Suspension
Ratcliff Christopher Home Help Pontiac 1/25/2016 MDHHS Terminated Lakeshore Home Health Care Inc Rathod Babubhai Group 1396858775 Ludington 2/22/2012 DCH 8/1/2013 DCH-OIG Suspended Lakeshore Spine & Pain PC Terminated (Accessible Urgent Care) Rathod Babubhai Group 1699043299 Ludington 2/22/2012 DCH 8/3/2013 DCH-OIG Suspended Terminated Lakeshore Home Health Care Inc Rathod Shaila Group 1396858775 Ludington 2/22/2012 DCH 8/3/2013 DCH-OIG Suspended Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Terminated Summary Raval Pramod Physician 1386612612 Hamtramck 4301043240 3/29/2010 DCH 7/18/2013 DCH-OIG Suspension Raval Sumanray Home Help Farmington Hills 6/16/2021 HHS-OIG Suspended
Summary Suspension Glendale Pharmacy Raval Vijay Kumar Pharmacy 1366765083 Highland Park NCPDP 2373809 8/19/2011 DCH 7/11/2016 MDHHS-OIG Termination Ray Marquetta Home Help Detroit 4/11/2016 MDHHS Rayshon Craig D Home Help Detroitq 9/17/2021 MDHHS
MI-Licensing MI-Bureau of and Licensing and Regulatory Regulatory Suspended Rea Lauralee Social Worker 1407155534 Grand Rapids 680189086 3/31/2020 Affairs 7/28/2020 Affairs Suspended Redd Clara C Home Help Allen Park 1/28/2015 DCH Reed Chance Home Help Detroit 3/26/2019 MDHHS Reed Lawanda Lorena Home Help Grand Rapids 12/15/2014 DCH Reed Vira Home Help Detroit 12/17/2019 MDHHS Reed David Home Help Detroit 11/21/2016 MDHHS Reed-Davenport Deshawn Home Help Saginaw 8/1/2019 MDHHS Reid Jaronn Home Help Taylor 6/5/2017 MDHHS Reid John Andrew Home Help Canton 3/16/2015 DCH Reid Larry Home Help Detroit 12/19/2016 MDHHS
MI-Licensing and Regulatory Reid Larry Physician 1801008727 Oak Park 5101007021 1/2/2021 Affairs Suspended Reitz Robert Home Help Three Oaks 4/19/2021 MDHHS-OIG Suspended
MI-Licensing and Regulatory Rejano Crispo Garcia Physician 1043379530 Trenton 4301033625 10/8/2009 Affairs Revoked Summary Suspension Personal Care Home Services Rembert Carmen Home Help Agency Southfield 3/20/2019 MDHHS-OIG 5/22/2020 MDHHS-OIG Terminated Summary Suspension Rembert Carmen Home Help Detroit 3/20/2019 MDHHS-OIG 5/22/2020 MDHHS-OIG Terminated Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Reyes Janice Renee Home Help Detroit 11/30/2015 MDHHS Reynolds Don Home Help Detroit 12/7/2017 MDHHS Reynolds January Home Help Grand Rapids 6/8/2017 MDHHS Reynolds Stacey Home Help Pontiac 11/9/2017 MDHHS
MI-Licensing and Regulatory Summary Reznick Terry Physician 1295874451 Fenton 5101009942 4/20/2017 Affairs Suspension Ribbentrop Paul H. Physician St. Clair Shores 5101003921 5/20/2003 HHS 1128(a)(4) Rice Brandy Home Help Clinton Township 1/15/2019 MDHHS Rice Darlene Home Help Detroit 8/7/2018 MDHHS Rice William Home Help Portage 7/13/2020 MDHHS Richard Lawrence B. Podiatrist 1972565448 Northville 5901001176 4/19/2015 HHS Excluded Richardson Angela Home Help Detroit 9/20/2017 MDHHS Richardson Neil James Chiropractor Grand Rapids 2301006727 7/6/1997 HHS 1128(b)(14) Richardson Rhonda Home Help Benton Harbor 2/8/2018 MDHHS Richey Linda Home Help Lewiston 12/30/2019 MDHHS Richmond Adam Home Help Wyoming 1/16/2018 MDHHS 6/16/2020 MDHHS
MI-Licensing and Regulatory Summary Richter Daniel Social Work 1578905402 Lowell 6801086657 12/26/2019 Affairs Suspension Non-Emergency Ridal David Transportation Grayling 12/4/2018 MDHHS Riddle Edward Home Help Kalamazoo 2/16/2017 MDHHS Rider Janis Home Help Ludington 11/8/2018 MDHHS Ridgell Sabrina Home Help Detroit 8/22/2019 MDHHS Ridout Jermaine Home Help Detroit 7/1/2019 MDHHS Summary Harper Pharmacy Rifai Mahmoud Pharmacy 1295166759 Harper Woods 5301010253 7/15/2019 MDHHS-OIG Suspension
MI-Licensing MI-Licensing and and Discplinary Regulatory Regulatory Limited Riker Paul Dentist 1750402137 Allen Park 2901014570 1/12/2019 Affairs 6/5/2019 Affairs Suspended Bertlyn Riley (Bert) Home Help Ypsilanti 9/5/2018 MDHHS Riley Donzell Home Help Detroit 2/13/2019 MDHHS Riley Shandell Lapep Home Help Grand Rapids 4/6/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Summary Ringley Pamela Ann Nurse Practitioner 1134539281 Howell 4704165210 9/8/2015 Affairs Suspension Robart Nicole Home Help Muskegon 12/18/2017 MDHHS Robb Casey Home Help Mount Morris 7/10/2018 MDHHS Roberts Alyssa Home Help Carleton 4/24/2018 MDHHS Roberts Patrick Home Help Detroit 11/7/2016 MDHHS Roberts-Bey Wesley Home Help Flint 11/18/2014 DCH Robertson Antoine Home Help Detroit 5/31/2016 MDHHS
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Robertson Jonathan G Physician 1366710816 MArquette 5101019483 9/11/2018 Affairs 12/18/2018 Affairs Revoked
MI-Licensing and Regulatory Disciplinary Robins Diana Nurse Practitioner 1568529618 Shelby Township 4704157677 10/6/2018 Affairs Limited Robinson Arthur Home Help Detroit 3/3/2016 MDHHS Robinson Betty Home Help Detroit 1/23/2020 MDHHS Robinson Corinne Home Help Clarkston 5/22/2018 MDHHS Robinson Demelle Home Help Detroit 10/16/2019 MDHHS Robinson Donald Home Help Detroit 9/21/2016 MDHHS Robinson Harold Home Help Southfield 8/2/2017 MDHHS Robinson Joyce Home Help Detroit 9/25/2018 MDHHS-OIG Robinson Kinte Home Help Ypsilanti 1/2/2018 MDHHS Robinson Laurence Home Help Detroit 2/24/2015 DCH 1/30/2018 MDHHS Robinson Leondre Home Help Benton Harbor 5/16/2018 MDHHS Robinson Philip Home Help Detroit 8/31/2015 MDHHS Robinson Phyllis Home Help Port Huron 4/19/2018 MDHHS Robinson Rosland Home Help Pontiac 2/8/2021 MDHHS Robinson-Crowell D'ett L Home Help Roseville 2/24/2015 DCH Roby Thomas Home Help Detroit 10/29/2016 MDHHS Rochefort Rocky Home Help Oscoda 5/17/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
HHS MI-Licensing Summary and Suspension 4/20/2017 Regulatory Excluded 7/19/2018 Affairs Revoked Rockafellow Bradley Psychologist 1558342378 Oxford 6301014045 7/6/2016 MDHHS-OIG 1/10/2019 MDHHS-OIG Terminated Rodriguez Pete Home Help New Era 12/10/2018 MDHHS Roe-Carney Treka Home Help Clarkston 6/11/2015 DCH Rogers Kyla Home Help Lansing 8/24/2020 MDHHS Rojas Humberto Physician Owosso 4301044894 10/20/2002 HHS 1128(a)(4) Rollins Jawanne J Home Help Detroit 11/3/2014 DCH Rollins Jerry Home Help Highland Park 5/17/2017 MDHHS Rollins Kevin Home Help Detroit 10/13/2014 DCH Rone Alvin D Home Help Muskegon Heights 11/30/2015 MDHHS 3/12/2018 MDHHS-OIG Rone Jimmy Home Help Muskegon 1/9/2015 DCH Rosa Blanca Home Help Detroit 9/18/2017 MDHHS Rose Edward Allen Physician 1750354106 Novi 4301046183 10/31/2013 HHS 1128(b)(4) Summary Rose Jermaine Home Help Detroit 1/26/2021 MDHHS-OIG Suspension Rose Karen Eileen Physician 1568406007 Novi 4301066589 10/31/2013 HHS 1128(b)(4) Roshy Gary L. Chiropractor Ludington 2301005366 12/7/2004 HHS 1128(b)(14) Ross Deaundray Home Help Detroit 4/25/2019 MDHHS Ross Guy Home Help Detroit 11/2/2016 MDHHS Ross Joseph Home Help Detroit 10/21/2019 MDHHS
MI- Licensing Summary and Suspension Regulatory Summary 10/13/2017 Affairs Suspension Roth Michael A Physician 1396893061 Famington Hills 4301028327 8/9/2016 MDHHS-OIG 8/31/18 MDHHS-OIG Terminated
MI-Licensing and Regulatory Roth Steven J Physician 1538123609 Waterford 5101006341 11/4/2017 Affairs Suspended Summary Suspension 11/29/2018 MDHHS-OIG Terminated Roumayah Najah Dental Group 1255419958 West Bloomfield 2901014824 8/15/2017 MDHHS-OIG 8/20/2019 HHS-OIG Excluded Roundtree Shawn Home Help Grand Rapids 11/21/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Rouser Cherrie Home Help Lansing 11/12/2016 MDHHS Rouser Kendrick Home Help pontiac 11/14/2018 MDHHS Roy Tracie L Home Help Baldwin 1/30/2015 DCH Rucker Demetrious Home Help Detroit 9/24/2015 MDHHS Ruffin Leonard Home Help Detroit 7/10/2015 DCH 4/18/2018 MDHHS Ruiz Aaron Home Help Ottawa 4/7/2020 MDHHS Runyon Betty Lou Home Help Whittemore 5/31/2017 MDHHS Runyon Hillary Home Help Ypsilanti 5/6/2019 MDHHS Rushing Kamesha Home Help Pontiac 9/9/2019 MDHHS Rushing Tony Home Help Kalamazoo 6/7/2018 MDHHS Russell Carlesia Home Help pontiac 11/8/2017 MDHHS Trio-Camburn Drugs Russell James W. Pharmacy Flint 4/20/1998 HHS 1128(b)(1)
MI-Licensing and Regulatory Russell Jeffrey S Physician 1497799654 Coldwater 5101011799 1/27/2014 Affairs Suspended Russell Renarad E Home Help Adrian 12/12/2014 DCH
MI-Licensing and Regulatory Summary Affairs MI- Suspension Licensing and Summary 3/7/2019 Regulatory Suspension Russo Christopher Physician 1033442231 Warren 4301064161 1/2/2019 MDHHS-OIG 01/28/2020 Affairs Suspended Rutherford John W. Physician River Rouge 5101005008 7/24/1986 HHS 1128(a)(1) Rutherford Willie Home Help Detroit 7/22/2020 MDHHS Ryan Carla Home Help Prudenville 2/15/2018 MDHHS Ryans Larry Home Help Saginaw 11/5/2014 DCH Ryniak Jessica Home Help Clinton Township 7/30/2019 MDHHS Summary Suspension 4/19/2015 HHS-OIG Excluded Sabit Aria Physician 1659510972 Southfield 4301097955 3/10/2015 DCH-OIG 04/26/2017 MDHHS-OIG Terminated Summary AGSS Properties LLC Sadeghi Azar Home Help Agency Ann Arbor 8/29/2017 MDHHS-OIG Suspension Summary Sadeghi Azar Home Help Ann Arbor 8/29/2017 MDHHS-OIG Suspension Saeed Jalal Home Help Dearborn 4/22/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Detroit New Hope Pharmacy Saiyad Maksudali Pharmacy 1861911208 Detroit 5301009534 8/5/2020 MDHHS-OIG Suspended Saladino April Managing Employee Grand Rapids 2/28/2019 MDHHS Exlcuded Salame Ali Home Help Dearborn 4/21/2021 MDHHS Summary City Limit LLC Salamey Tarick Group 1689130056 Detroit 12/18/2019 MDHHS-OIG Suspension Saleh Saeed Physician Dearborn 4301031271 6/19/2003 HHS 1128(b)(4) Salinas Fabian Physician Ann Arbor 4301076437 9/20/2005 HHS 1128(a)(2) Salter Norris Home Help Mount Clemens 11/30/2015 MDHHS Samuel Louis Home Help Detroit 9/13/2018 MDHHS Samuel Tyrus Phillip Home Help Eastpointe 4/9/2015 DCH Summary Rochester Hills Medical Center Suspension PC Samy Chris Medical Group 1700094687 Rochester Hills 8/6/2018 MDHHS-OIG 9/5/2018 MDHHS-OIG Terminated
Mi- Licensing and Regulatory Suspended MI-Licensing Affairs MI - Summary and Licensing and Suspended Regulatory 11/21/2016 Regulatory Voluntarily Samy Chris D Physician 1740211655 Rochester Hills 4301061131 11/21/2016 Affairs 03/21/2017 Affairs Surrendered Sanchez Christina Louise Home Help Perrinton 10/20/2014 DCH Sanchez Manuel Home Help Lansing 7/23/2020 MDHHS Sanders Celestine Home Help 1700040110 Ypsilanti 6801064039 5/20/2019 HHS-OIG Excluded Sanders Darrell Home Help Detroit 5/8/2018 MDHHS Sanders Deshawn A. Home Help Detroit 3/3/2021 MDHHS Sanders Jarett Home Help Detroit 9/29/2015 MDHHS Sanders Phillip Home Help Harperwoods 12/16/2019 MDHHS Sanford Eugene Home Help Detroit 2/28/2019 MDHHS Santana Henry Home Help Detroit 7/27/2017 MDHHS Santos rafael Home Help Lansing 6/12/2017 MDHHS Sapala, James A., MD PC Sapala James A. Physician Group 1720086374 Detroit 4301030372 5/4/1992 HHS 1128(a)(1) Summary MDHHS-OIG Suspension MI-Licensing MI - Licensing Summary and and Suspension Regulatory 3/15/2017 Regulatory Summary Saperstein Glenn S Physician 1770637670 Commerce Township 5101011716 2/1/2017 Affairs 08/03/2017 Affairs Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Saunders- Counselor Summary Davenport Khadisha Home Help 1447422860 Southfield 6401009009 3/30/2021 MDHHS-OIG Suspension Sawaf Ali H. Physician Escanaba 4301033342 8/19/2004 HHS 1128(a)(4) Sawyer Amber Home Help South Lyon 8/3/2017 MDHHS Saxton Kodi Home Help Detroit 11/30/2015 MDHHS Sayen Tara Home Help Imlay City 4/18/2016 MDHHS 12/23/90: 1128(b)(3) 5/5/1994: Scalici Tony F. Physician Wyoming 5101007093 12/23/1990 HHS 5/5/1994 HHS 1128(b)(3) Schaffer Malena Home Help Fenwick 9/27/2016 MDHHS Termination Summary Schanzenbaker Sherrie Counselor 1427471036 Battle Creek 6401017043 8/12/2020 MDHHS-OIG 12/6/2020 MDHHS-OIG Suspension Schef Debra Home Help Port Huron 5/27/2016 MDHHS 2/4/99: Violation of Medicaid False Claim Act 5/20/99: Schiefelbein Arthur J. Podiatrist Highland Park 5901000899 2/4/1999 DCH 5/20/1999 HHS 1128(a)(1)
MI-Licensing and Regulatory Voluntarily Schillio Serge Paul Physician 1194761940 Saint Jospeh 4301051134 8/16/2013 Affairs Surrendered Schneck Michael Home Help Gaylord 9/14/2017 MDHHS Schooler Eunice Home Help Barryton 3/28/2019 MDHHS Schrade Moichael Home Help Warren 8/27/2021 MDHHS Schreier Steven M. Podiatrist Southfield 5901400211 11/19/1998 HHS 1128(a)(1)
MI-Licensing and Disciplinary Regulatory Limitd Schrock Lauralee Physician Assistant 1952738189 Dearborn 5601006841 9/27/2017 Affairs License Howard City Plaza, Inc. Schroeder Bruce Pharmacy Howard City 5301002282 12/23/1991 HHS 1128(a)(1) Schroeter David B. Dentist Macelus 2901011501 11/20/1997 HHS 1128(b)(4) Schubpack Tara Home Help Bay CIty 11/3/2017 MDHHS Schudel Jenny Home Help Roscommon 3/1/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Schultz Nancy L Nurse Practitioner 1588638589 Montague 4704218106 8/14/2016 Affairs Suspended Schultz Yvonne Home Help Port Huron 9/16/2015 MDHHS Terminated Schutte Natalie Physician Assistant 1295982189 Mount Pleasant 5601005332 2/22/2012 DCH 8/7/2013 DCH Suspended Violation of Medicaid False Claim Schwartz Gary J. Chiropractor 1326249624 Jackson 2301002137 6/8/1994 DCH Act Schwarz Bernard C. Chiropractor 2301005101 12/7/1994
Summary Suspension Schwarzmedics Schwarz Daniel Group 1073959615 Saginaw 12/25/2019 MDHHS-OIG 1/18/2021 MDHHS-OIG Termination Summary Schwarz Daniel Physician 1669665154 Southfield 4301062570 12/25/2019 MDHHS-OIG Suspension Scott Dante J Home Help Muskegon 1/14/2015 DCH Scott Eliza Home Help Zeeland 3/29/2016 MDHHS Scott Karla Jean Home Help Benton Harbor 6/17/2015 DCH Scott Karley Home Help Roseville 6/28/2017 MDHHS Scott Mary Home Help Detroit 6/17/2015 DCH Scott Ricky Home Help Detroit 11/30/2015 MDHHS Scott Terry Junior Home Help Bangor 5/15/2015 DCH 1/10/14 Summarily Suspended 2/9/2014 Scott Van Edward Physician 1164575031 Muskegon Heights 4301044463 1/10/2014 DCH-OIG 2/9/2014 DCH-OIG Terminated
MI-Licensing Summary and Suspension Regulatory Summary Scranton Steven E Physician 1578543476 Grand Rapids 4301043798 3/5/2018 MDHHS-OIG 3/23/2018 Affairs Suspension Seay Dawn Home Help Lansing 8/19/2015 MDHHS Self Freeman Home Help Detroit 1/18/2017 MDHHS Sellers Roqueena Home Help Detroit 9/27/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Disciplinary Limited Sennish John C. Physician 1750350286 Coldwater 4301043259 6/26/2018 MDHHS License Summary Sewell Franklin Home Help Detroit 7/20/2020 MDHHS-OIG Suspenion
MI-Licensing and Regulatory Shader Joseph Physician 1972804193 North Liberty, IA 4301111585 4/29/2018 Affairs Suspended Shadon Dwight Home Help Hamtramck 1/29/2020 MDHHS Summary Suspension Shafinia Sohrab Physician 1588614606 Farmington Hills 5101012201 5/6/2014 DCH-OIG 12/20/2014 HHS Excluded
MI-Licensing and Regulatory Voluntarily Shah Rajesh P Physician 1376595272 Jackson 4301048647 5/17/2017 Affairs Surrendered
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Voluntarily Shaheen Michael G Physician 1285732073 Flint 5101006847 8/31/2017 Affairs 5/5/2018 Affairs Surrendered Shamoon Jivry Home Help Warren 5/8/2017 MDHHS
Shanidze Irakly Home Help Grosse Pointe Park 9/20/2006 HHS-OIG Excluded Shannon Larry Home Help Detroit 10/31/2016 MDHHS
MI-Licensing MI-Bureau of Summary and Licensing and Suspension Diaa AL Dien Regulatory Regulatory Summary Sharif Ayoub Physician 1487919296 Grand Blanc 4301100775 10/10/2016 Affairs 2/10/2017 Affairs Suspension Summary Sharma Dana Home Help Sterling Heights 2/20/2017 HHS Suspension Summary Tawas Bay Family Practice PC Sharma Devendra Rural Health Clinic 1275509036 Tawas City 11/19/2018 MDHHS-OIG Suspension Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing Summary and Suspension Regulatory Summary Sharma Devendra Physician 1396740817 Tawas City 4301033122 11/19/2018 MDHHS-OIG 4/8/2019 Affairs Suspension Sharow Debbie Lynn Home Help Prudenville 12/2/2014 DCH
MI-Licensing and Regulatory Voluntarily Sharp Michael J Dentist 1245316785 Ann Arbor 2901010733 10/11/2012 Affairs Surrendered Sharp Veronica Home Help Detroit 3/1/2018 MDHHS Sharrak Christopher Home Help Bloomfield 12/10/2015 MDHHS Shaw TImothy Home Help Detroit 11/12/2020 MDHHS Shaya Stevonna Home help Sterling Heights 6/18/2018 MDHHS Sheard Donna Home Help Saginaw 9/29/2015 MDHHS Sheffield Kwame Home Help Taylor 11/30/2015 MDHHS Summary Sheikh Zahid Physician 1720045586 Madison Heights 4301058357 11/14/2017 MDHHS-OIG Suspension Summary St. Claire Shores Medical PLLC Shelton Bernard Group 1316194640 Saint Claire Shores 3/26/2019 MDHHS-OIG Suspension
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Shelton Bernard Physician 1417032491 Saint Claire Shores 4301088798 1/13/2017 Affairs 7/12/2017 Affairs Suspended Shelton Jennifer Home Help Benton Harbor 9/4/2019 MDHHS Shepherd Anthony Eugene Home Help Detroit 11/30/2015 MDHHS Shepherd Christine Home Help Sturgis 11/16/2020 MDHHS Shepherd Nikyta Home Help Ypsilanti 1/27/2018 MDHHS Shepherd Rorey Home Help Grand Rapids 8/8/2018 MDHHS Sheppard-Morris Malissa Home Help Battle Creek 11/13/2018 MDHHS
MI-Licensing MI-Licensing and and Regulatory Regulatory Suspension Sherman Bryan R Physician Assistant 1346458130 Ann Arbor 5601004136 1/13/2016 Affairs 6/2/2016 Affairs Revoked Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Summary Sherman Errol Podiatrist 1154344117 Oak Park 5901000864 4/27/2011 Affairs Suspension
MI-Licensing and Summary Regulatory Suspension Sherman, Errol DPM PC Sherman Errol Podiatrist 1770507147 Oak Park 5901000864 4/27/2011 Affairs 6/9/2015 DCH - OIG Terminated Sherman Matthew Home Help Ferndale 10/25/2017 MDHHS
MI-Licensing and Regulatory Voluntarily Sherwood Craig Physician 1588628564 Saint Jospeh 5901001102 11/20/2018 Affairs Surrendered Shields Siobham Home Help Grand Rapids 12/15/2015 MDHHS Sholes Carlton Home Help Alpena 4/16/2018 MDHHS Short Gary Home Help Hart 9/29/2017 MDHHS Shufford Luvenia Home Help Kenosha 12/15/2014 DCH Shumaker Ryan Home Help Kalamazoo 11/21/2019 MDHHS
Suspension by the State Siebert John W. Physician 1063594521 Madison, WI 50002 6/13/2013 Other State of New York Summary Suspension Siegel Barry G MD PC Siegel Barry Group 1164625687 Rochester Hills 6/11/2019 MDHHS-OIG 9/13/2019 MDHHS-OIG Terminated Summary Suspension Siegel Barry Physician 1619967197 Birmingham 4301045655 6/11/2019 MDHHS-OIG 9/13/2019 MDHHS-OIG Terminated Sigger Menard Home Help Detroit 7/14/2016 MDHHS
MI-Licensing and Regulatory Summary Silber Alan Physician 1366447260 West Bloomfield 4301085080 6/20/2011 Affairs Suspensions Silvia Kimberly Home Help Niles 11/20/2018 MDHHS Simila Denise Home Help MArquette 3/8/2018 MDHHS Non-Emergency Simmons Kim Transportation Detroit 12/14/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Simmons Tara Wokeim Home Help Detroit 11/26/2014 DCH Simon Elvea Home Help Detroit 11/17/2017 MDHHS Simpson James Vernon Dentist St. Helen 2901015390 11/8/1994 HHS 1128(b)(3) Simpson Jessica Home Help Southfild 10/8/2020 MDHHS Simpson Kauba Home Help Detroit 9/18/2017 MDHHS Simpson Lonnie Home Help Detroit 5/3/2017 MDHHS Sims Arlester Home Help Muskegon 8/4/2016 MDHHS Sims Utasha R Home Help Muskegon 4/27/2020 MDHHS
MI-Licensing and Regulatory Sirajuddin James Physician 1306997325 South Haven 4301039518 9/7/2014 Affairs Suspended
MI-Licensing and Regulatory Voluntarily Sirois Cindy Physician 1093791733 Fort Lauderdale, FL 4301090877 3/20/2019 Affairs Surrendered Siryani Mervat Home Help Warren 10/31/2019 MDHHS-OIG Terminated Siterlet Felipa T. Home Help Algonac 3/9/2021 MDHHS Summary Suspension Siudara Jerome Physician 1598941346 Cheboygan 5101005875 4/4/2016 MDHHS-OIG 1/10/2019 MDHHS-OIG Terminated Summary Skinner Charelene Home Help Lansing 5/19/2015 DCH-OIG Suspension Skinner Michael W Home Help Lansing 3/10/2015 DCH Sklar Eugene Dentist Gaylord 2901008434 11/4/1990 HHS 1128(b)(4)
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Voluntarily Slater Blake Physician 1134188733 Cedarville 5101007998 10/10/2018 Affairs 2/7/2019 Affairs Surrendered Slusher Stephen L. Chiropractor Escanaba 2301007042 1/20/2003 HHS 1128(a)(4) Smakal Gary Home Help Lake George 4/29/2015 DCH Smith Alice Home Help Detroit 4/16/2018 MDHHS 8/23/2021 MSHHA Smith Anthony Home Help Kalamazoo 8/7/2018 MDHHS Smith Antonio Home Help Detroit 1/7/2016 MDHHS Smith Bobby Home Help Detroit 10/28/2015 MDHHS 3/24/2021 MDHHS Smith Calvin Home Help Detorit 10/7/2020 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Summary Regulatory Suspension Affairs MI- Summary Licensing and Suspension 10/18/2019 Regulatory Voluntarily Smith Carlos A Psychologist 1811270895 Livonia 6301017313 8/13/2018 MDHHS-OIG 06/25/2020 Affairs Surrendered Smith Chrismoul Home Help Detroit 9/2/2021 MDHHS Summary Smith Dwight E Physician 1114942562 Detroit 4301046520 5/29/2012 DCH Suspension Smith Eric W Home Help Detroit 10/31/2017 MDHHS Smith Franzora Home Help Detroit 12/15/2014 DCH Smith Gregory Andre Home Help Detroit 5/18/2015 DCH Smith Jamila Home Help Detroit 12/22/2015 MDHHS Smith Jennie Home Help Pontiac 3/9/2016 MDHHS 8/3/2020 MDHHS Smith Joe Home Help Saginaw 3/25/2015 DCH Smith Johnell Home Help Detroit 4/25/2018 MDHHS Smith Kenneth Home Help Detroit 7/11/2019 MDHHS Smith Krista Marie Home Help Saint Helen 2/7/2019 MDHHS Smith Kyron Home Help Inkster 3/8/2018 MDHHS Smith Lindsie Home Help Houghton Lake 3/5/2019 MDHHS Smith Michael Home Help Jackson 10/31/2017 MDHHS Smith Mirthus T Home Help Newport 11/30/2015 MDHHS Smith Raelynn Home Help Grand Rapids 2/20/2015 DCH Smith Ray Home Help Farwell 5/26/2015 DCH
MI-Licensing and Regulatory Voluntarily Smith Rodney W Physician 1871533554 Ann Arbor 4301063441 8/23/2019 Affairs Surrendered Summary Smith Ronald Physician 1881642999 Las Vegas 1178 6/22/2020 MDHHS-OIG Suspension Smith Sandra Home Help Beaverton 1/25/2016 MDHHS Smith Shannon Home Help East China 9/14/2016 MDHHS
Smith Sheila Home Help Detroit 6/10/2020 MDHHS -OIG Suspension Smith Steven Home Help Holt 10/2/2018 MDHHS Smith Stevonna Home Help Detroit 4/4/2017 MDHHS Smith Tandre Home Help Flint 6/27/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Smith Thomas E Home Help Detroit 11/30/2015 MDHHS Smith Victoria Home Help West Branch 3/29/2021 MDHHS Smith William Lee Home Help Detroit 11/30/2015 MDHHS Smith Yvette Home Help Grand Rapids 1/28/2017 MDHHS Smith Robert Home Help Algonac 2/17/2017 MDHHS Summay Sneed Lamyia Home HElp Detroit 6/16/2020 MDHHS-OIG Suspension Sneed Miykiah Home Help Jackson 4/13/2020 MDHHS Snyder Jonathan Home Help Kalkaska 8/29/2017 MDHHS Soarks Lisa Home Help Manistee 10/31/2019 MDHHS Summary Suspension 9/20/2017 HHS-OIG Exclusion Sokoll William C Physician 1639181753 Standish 4301046279 5/6/2014 DCH-OIG 11/01/2019 MDHHS-OIG Terminated Soliman Mikhayl Physician 1356536460 Wayne 4301086758 7/3/2013 DCH-OIG Suspended Summary Solo Robert Home Help Kalkaska 1/26/2021 MDHHS-OIG Suspension
MI-Licensing and Regulatory Sonaglia Catherine S Physician 1275644601 Grosse Pointe Woods 4301058067 7/2/2020 Affairs Suspended
Summary Suspension MI-Licensing Summary and Suspension 8/6/2019 Regulatory Terminated 11/01/2019 Affairs Voluntarily Sood Usha Physician 1255447215 Roseville 4301039212 3/5/2018 MDHHS-OIG 06/19/2020 MDHHS-OIG Surrendered Sorensen Phillip M. Physician Lansing 4301031657 4/20/2003 HHS 1128(a)(3) 4/30/99: Violation of Medicaid false Claim Act 5/18/00: Sorongon Marcelino Physician Saginaw 4301031149 4/30/1999 DCH 5/18/2000 HHS 1128(a)(1) Sorrell Michael Home Help lansing 1/4/2018 MDHHS Souvenir Kaye A. Dentist Detroit 2901012399 8/15/1993 HHS 1128(a)(1) Sparkman Garry Home Help Clinton Township 7/23/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Sparks Sirena Home Help Manistee 5/14/2019 MDHHS Spears Dersell Home Help Detroit 1/9/2018 MDHHS Speed Kenneth Home Help Lansing 11/30/2015 MDHHS Speller Kevin S Home Help Ecorse 2/13/2015 DCH Spencer Demarcus Home Help Holland 10/14/2019 MDHHS Spencer Jarvis Home Help Detroit 5/19/2021 MDHHS Summary Spires Ricky Home Help Madison Heights 4/13/2020 MDHHS-OIG Suspension Sripinyo Veera Physician Warren 4301031589 5/6/1997 HHS 1128(b)(4) Suspended St. Amor Stephen Home Help Romulus 12/2/2015 MDHHS 1/6/2016 Terminated Stachulski Holly C Home Help Taylor 4/20/2017 HHS Excluded Stalling Alonzo Home Help Detroit 3/28/2019 MDHHS Stanford Donna Home Help Southfield 11/5/2014 DCH Stanford Kemonta Home Help Detroit 10/3/2017 MDHHS Stang Robert Martin Physician Monroe 5101012881 10/19/2006 HHS 1128(a)(2) Stanley Darius Home Help Southfield 5/20/2019 MDHHS Starks DeAndre Home Help Detroit 6/11/2021 MDHHS Starks Jodie Home Help Detroit 5/6/2015 DCH Starks Ladonna Home Help Highland Park 12/15/2016 MDHHS Starks Sandra Home Help Kalamazoo 5/19/2015 DCH Starr Veronica Home Help Warren 2/11/2014 DCH-OIG 7/1/2015 MDHHS-OIG Terminated Statler Erin Home Help St. Joseph 9/14/2016 MDHHS Steele Coszetta Home Help Jackson 4/27/2015 DCH Stephens Dontrail Dwayne Home Help Benton Harbor 11/2/2015 MDHHS Sterling Precious Ebony Home Help Benton Harbor 6/10/2015 DCH Sterner Patricia Home Help Auburn 1/25/2021 MDHHS Stetz Michael N. Chiropractor Lansing 2301006648 4/20/2003 HHS 1128(a)(3) Stevenson Michael Home Help Eastpointe 4/12/2021 MDHHS Stevenson William Home Help Detroit 9/16/2019 MDHHS Steward Eric Home Help Detroit 1/21/2020 MDHHS Steward Travis Home Help Detroit 11/24/2014 DCH Stewart Frederick Home Help Saginaw 9/29/2015 MDHHS Stewart LaToya Home Help Warren 2/10/2020 MDHHS Stewart Perry Home Help Detroit 11/20/2018 MDHHS Stewart Ronald Home Help Detroit 1/30/2015 DCH Stewart Tequila Home Help Grand Rapids 8/5/2015 DCH Stewart Yvette Home Help Pontiac 4/27/2021 MDHHS Stimmer Leonard Home Help gaylord 5/18/2017 MDHHS Stone Dontae Home Help Detroit 7/16/2018 MDHHS Stoneburgh Michael Home Help Port Huron 1/17/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Voluntarily Strampel William Physician 1114954286 Dewitt 5101014110 8/22/2019 Affairs 12/5/2019 Affairs Surrendered 12/03/2013 Summarily Suspended 01/02/2014 Strausbaugh C Jay Physician Assistant 1780777953 Southgate 5601004882 12/3/2013 DCH-OIG 1/2/2014 DCH-OIG Terminated Strickland Ronald Home Help Atlanta, GA 5/16/2019 MDHHS Stringfellow Terry Home Help Dearborn Heights 3/12/2018 MDHHS Strouse Kim Home Help Grand Rapids 2/8/2017 HHS-OIG Strugach Vitality Home Help West Bloomfield 9/21/2016 MDHHS
MI-Licensing and Regulatory Summary Stuenkel Terri M Physician 1568511426 Deckerville 5101012732 10/24/2015 Affairs Suspension
Suspended, MI-Licensing failure to and meet cont. Regulatory ed. Sturm Brandon Chiropractor 1295815223 Brighton 2301007506 1/21/2011 Affairs Requirement Summary Complete Family Health Care Subnani Madhu Group 1861662967 Imlay City 1/12/2021 MDHHS-OIG 1/12/2021 Suspension Summary Subnani Madhu Physicain 1609920354 Rochester Hills 4301055014 1/12/2021 MDHHS-OIG Suspension Sullivan Frank Home Help Midland 12/12/2019 MDHHS Summary Sullivan Michael Dentist 1649457300 Detroit 2901019909 1/12/2021 MDHHS-OIG Suspension Sullivan Themelian Home Help Detroit 11/30/2017 MDHHS Sullivan Timothy Home Help Detroit 10/9/2018 MDHHS Summerfiled Claudia Home Help Warren 8/24/2015 MDHHS Summers Darrell Home Help Bridgman 7/8/2020 MDHHS-OIG Terminated Summers Tobias Home Help Detroit 4/15/2021 MDHHS Sumner Brian Home Help Jackson 10/16/2019 MDHHS
Voluntarily Surapipith Pongchayut Physician 1003877481 Flint 4301044139 2/27/2009 DCH surrendered Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary Surya Nallani C Physician 1801838651 Birmingham 4301073842 3/6/2013 DCH Suspended Suttles Barbara Home Help Detroit 11/30/2015 MDHHS Sutton Marion David Physician Sanford 4301033071 7/8/1993 HHS 1128(a)(2) Swan John Physician 1003269911 Saint Claire Shores 5101022858 8/3/2020 MDHHS-OIG Suspended Ohio Swayngim Dowzell Physician 1427035757 Sandusky, OH 35041426 9/4/2021 Licensing Revoked Summary Sylvester Tyie Home Help Detroit 5/12/2020 MDHHS-OIG Suspension Summary Talbot Jennifer Counselor 1689938094 Sterling Heights 6401011865 4/12/2021 MDHHS-OIG Suspension Taliaferro Maurice Home Help Kalamazoo 5/19/2016 MDHHS Tallo Sumoud Home Help Sterling Heights 6/19/2018 MDHHS Tansil Ginger M Home Help Kent City 3/12/2015 DCH Tapert Richard E. Physician Detroit 10/20/1999 HHS 1128(b)(4) Tashjian James S. Physician Birmingham 4301028804 4/30/1992 HHS 1128(b)(1) Tate Corey Home Help Lincoln Park 1/9/2015 DCH Tatum Michael Lawrence Home Help Detroit 11/30/2015 MDHHS Taylor Anastacia J. Home Help Battle Creek 12/20/2020 MDHHS Taylor Angelique Home Help Westland 7/31/2019 MDHHS Taylor Arkisha Home Help Detroit 8/8/2018 MDHHS Taylor Clark E. Physician Cheboygan 5101005560 12/18/1997 HHS 1128(b)(4) Taylor Dario Home Help East Lansing 6/15/2017 MDHHS Taylor Jackie Home Help Muskegon 12/20/2016 MDHHS Taylor Jimmie Home Help Detroit 1/11/2018 MDHHS Taylor Kreighton Home Help Detroit 2/4/2021 MDHHS Taylor Rashad Home Help Detroit 2/27/2017 MDHHS Taylor Robert Home Help Detroit 2/5/2018 MDHHS Taylor Roosevelt Physician Flint 5101004568 6/28/1992 HHS 1128(b)(3) Teague Dennette Elaine Home Help Port Huron 12/1/2014 DCH Temple Frederick Home Help Saginaw 6/17/2015 DCH Terrell Gregory Home Help Eastpointe 1/12/2017 MDHHS Terrell Joann Home Help Detroit 4/25/2019 HHS-OIG Terrell Jose Home Help Southfield 4/9/2018 MDHHS Summary Terrell Kyekyenika Home Help Ypsilanti 5/27/2020 MDHHS-OIG Suspension Terrell Timothy Home Help Highland Park 3/20/2019 MDHHS Terry Antonio Home Help Detroit 1/15/2015 DCH Terry Maurice Home Help Detroit 4/11/2016 MDHHS Thepveera Kraingsak Physician 1922167246 Saginaw 4301032947 12/6/2016 MDHHS-OIG Therrien Jeremy Home Help Escanaba 5/19/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Thomas Charmaine Home Help Ann Arbor 5/16/2019 MDHHS Thomas Devin Home Help Detroit 1/23/2020 MDHHS Terminated Thomas Donald Home Help Sterling Heights 4/16/2018 MDHHS Thomas Ernest Home Help Detroit 1/23/2020 MDHHS Thomas Fred Home Help Flint 8/26/2021 MDHHS Thomas Keyanna M Home Help Saginaw 11/20/2014 DCH Thomas Larry Home Help Detroit 4/15/2020 MDHHS Thomas Maurice Home Help Detroit 2/19/2019 MDHHS Thomas Monica Home Help Westland 5/23/2019 MDHHS Thomas Tami Home Help Caseville 10/9/2018 MDHHS Thomas Terry Home Help Detroit 6/15/2016 MDHHS
MI-Licensing and Regulatory Voluntarily Thomas Timothy M Chiropractor 1205909660 Southgate 2301005050 8/25/2016 Affairs Surrendered Thomas Tony Lamar Home Help Detroit 5/22/2015 DCH Thomas Tonyetta Home Help Niles 11/30/2015 MDHHS Thomas Tawana Home Help Muskegon 1/7/2016 MDHHS Thomas-Flowers Jamie Home Help Muskegon Heights 10/2/2018 MDHHS Thompkins Kenneth Home Help Detroit 3/16/2018 MDHHS Thompson Andre K Home Help Flint 11/30/2015 MDHHS Thompson Andrea Home Help Kalamazoo 10/26/2020 MDHHS Thompson Audry Gale Home Help Detroit 4/1/2015 DCH Thompson Harrel Home Help Mt Clemens 10/17/2016 MDHHS Thompson Jamie Home Help Midland 6/23/2021 MDHHS Thompson Lee Home Help Grand Rapids 12/5/2019 MDHHS Thompson Lynzie Home Help Niles 6/5/2018 MDHHS Thompson Robert Eugene Physician 1447399720 Alpena 4301071670 12/20/2009 HHS 1128(b)(4) Thornton Mario Home Help Sterling Heights 4/10/2018 MDHHS Threlkeld Kenyatta Home Help Grand Blanc 2/10/2020 MDHHS Thurman Deborah Home Help Detroit 12/1/2014 DCH Thurman Leory Home Help Lansing 5/1/2017 DHHS
Tika Lovin Home Help Macomb Township 7/20/2015 DCH Tillery Terrence Home Help Detroit 11/16/2015 MDHHS Suspended and Tipton Patricia Home Help Flint 6/8/2015 DCH-OIG Terminated Tisdell Craig Home Help Bentoin Harbor 9/9/2015 MDHHS Tobias Angela Home Help Port Huron 5/11/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Tocco Peter Physician Pontiac 5101006837 3/8/1994 HHS 1128Aa Tolbert Jesse Home Help Iron Mountain 3/8/2018 MDHHS Tolbert KaShanka HomeHelp Pontiac 8/30/2021 MDHHS Toles marchetta Home Help Jackson 1/17/2018 MDHHS Tolton Shirley Home Help Detroit 9/15/2016 MDHHS Tombo Jose M. Physician Detroit 4301033662 1/10/1991 HHS 1128(b)(4) Toronjo Betty Home Help Midland 5/4/2017 MDHHS Tornes Eddrick Home Help Ypsilanti 6/4/2021 MDHHS
MI-Licensing MI-Bureau of and Licensing and Summary Regulatory Regulatory Suspension Torre Eduardo E Social Workeer 1073862454 Carrollton 6801093308 8/20/2019 Affairs 7/28/2020 Affairs Suspended Tossa Edward Home Help Warren 11/7/2016 MDHHS Touchstone Jontae Home Help Detroit 1/16/2020 MDHHS Terminated Town Gary Home Help Otsego 3/28/2016 MDHHS
MI-Licensing and Regulatory Summary Townsend Robert L Physician 1376537316 Gaylord 5101016296 12/18/2015 Affairs Suspension Summary Toya Sophie Physician 1225367147 West Bloomfield 4301111559 1/11/2021 MDHHS-OIG Suspension Trainor Charles Home Help Lansing 1/13/2020 MDHHS-OIG Trammell Howard Home Help Detroit 7/23/2019 MDHHS Terminated Comprehensive Foot & Ankle Summary Health, PC Tran Anmy Group 1942450127 Macomb 8/15/2013 DCH Suspension Terminated Tran-Lee Foot & Ankle Specialty Summary Center, PC Tran Anmy Group 1720201015 Clinton Township 8/15/2013 DCH Suspension 09/26/2011 Terminated 08/07/2013 Summary Tran Anmy Podiatrist 1184654188 Clinton Township 5901001910 9/26/2011 DCH 8/7/2013 DCH Suspension
Transor Johnnathan Home Help Dertroit 10/7/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Trepanier Carol Dentist 1932265899 Detroit 2901016776 5/21/2010 Affairs Suspended Trevino Esther Home Help Pontiac 4/18/2017 MDHHS Trice Yolanzo Home Help Kalamazoo 8/14/2018 MDHHS
MI-Licensing and Regulatory Tringali Anita L Nurse Practitioner 1851585228 Eastpointe 4704114479 8/16/2020 Affairs Suspended
MI-Licensing and Regulatory Summary Tripp Jessica S. Socail Worker 1477194595 Ferndale 6801086858 2/11/2021 Affairs Suspension Trosclair Wanda Home Help Sault Sainte Marie 12/20/2017 MDHHS Trotter Alice Home Help Lansing 10/28/2015 MDHHS Trotter Anthony Home Help Grand Rapids 9/15/2016 MDHHS Trowell Lawrence Home Help Detroit 5/4/2016 MDHHS Truman Glasper Home Help Jackson 2/10/2020 MDHHS Summary Trumble Kristine Home Help Alpena 4/6/2020 MDHHS-OIG Suspension Truschke Daniel Home Help White Cloud 10/28/2020 MDHHS
MI-Licensing and Regulatory Tschirhart James Michael Physician 1174559991 Saginaw 4301048766 5/16/2009 Affairs Suspended
MI-Licensing and Regulatory Summary Tubbs Craig Physician 1609892116 Alma 4301407461 6/11/2011 Affairs Suspension Tucker Anthony Home Help Wayne 8/29/2019 Tucker Darryl Home Help Detroit 12/5/2018 MDHHS Tucker Detuaine Deshawn Home Help Jackson 11/6/2014 DCH Tucker Juanita Home Help Detroit 9/17/2019 MDHHS Tunis Jonathan D. Physician Carson City 4301065350 3/20/2000 HHS 1128(b)(4) Tupper Jamal Home Help Detroit 9/9/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Turner Eligha Hoem Help Detroit 8/16/2021 MDHHS Turner Angela Home Help Muskegon 1/6/2016 MDHHS Turner Tamon Terrance Home Help Benton harbor 11/24/2014 DCH Turner-Comer Latiosha Home Help Detroit 1/30/2020 MDHHS Terminated Summary Tyler April Physician 1598789422 Fenton 5101011859 10/9/2018 MDHHS-OIG Suspension Tyler Mario Home Help Grand Rapids 6/11/2018 MDHHS
Tyner Shawntesse Home Help Detroit 10/22/2018 MDHHS Ucer Erol Physician Flint 4301031131 6/4/1995 HHS 1128(b)(1) Uithol Winifred Home Help Gladwin 11/30/2015 DCH Umphrey Samantha Home Help Alger 1/14/2017 MDHHS 5/6/03: Violation of Medicaid False Claim Act 5/20/03: Urbanik Michael S. Dentist Detroit 2901013979 5/6/2003 DCH 5/20/2013 DCH-OIG 1128(a)(1) Ureta III Sotero M Physician 1174545271 Cadillac 4301070002 1/13/2017 HHS Excluded Summary Suspension MI-Licensing Summary and 05/21/2013 DCH-OIG Suspension Regulatory 4/19/2015 HHS MDHHS- Excluded Utarnachitt Richard V Physician 1962539619 Clinton Township 4301033666 2/15/2015 Affairs 01/26/2016 OIG Terminated Summary Suspension 2/11/2016 MDHHS-OIG Terminated Vaid Mustak Y. Physician 1982619649 Livonia 4301085038 9/26/2011 DCH 01/20/2020 HHS-OIG Excluded Valdez Jose V. Physician Detroit 4301030159 9/2/1997 HHS 1128(b)(2) Summary Covenant Neurological Services Valentine Charise Medical Group 1669611059 Southfield 9/25/2018 MDHHS-OIG Suspension
MDHHS-OIG Summary MI-Licensing MI-Licensing Suspension and and Summary Regulatory 9/25/2018 Regulatory Suspension Valentine Charise Physician 1366485039 Southfield 4301053752 7/19/2018 Affairs 3/20/2019 Affairs Suspended Vallad Randall Home Help Hersey 6/28/2017 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Summary Van Der Weide Arie Physician 1679512966 Fremont 5101010310 1/19/2009 Affairs Suspension Summary MDHHS-OIG Suspension MI- Licensing Terminated 10/4/2018 and Summary 10/29/2018 Regulatory Suspension 2/6/2019 Affairs Suspended Van Gelder, MD Leonard Physician 1467447557 4301044632 9/4/2018 MDHHS-OIG 3/20/2019 HHS-OIG Excluded Vance Phillip Home Help 11/7/2019 MDHHS Vance Robert Home Help Benton Harbor 2/22/2017 MDHHS Vanhatten Amber Home Help Ypsilanti 1/31/2018 MDHHS VanHorn LaToya Home Help Kalamazoo 8/14/2018 MDHHS Vanner Kenneth Home Help Inkster 1/10/2018 MDHHS Vargas Dominic Home Help Onaway 4/7/2015 DCH
MI-Licensing MI-Licensing Summary and and Suspension Regulatory Regulatory Voluntarily Varney Michael W Psychologist 1861693848 Caspian 6301013523 7/3/2018 Affairs 6/27/2019 Affairs Surrendered Vartapev Alexander Home Help Hamtramck 4/7/2015 MDHHS Vaughn David Home Help Saginaw 8/24/2021 MDHHS Vaughn Paul Home Help Hastings 2/16/2017 MDHHS Veal JAmes Home Help Mout Clemons 3/19/2020 MDHHS 11/10/93: Violation of Medicaid MI-Licensing False Claim and Act Regulatory 8/10/94: Velez-Ruiz Wanda E. Physician 1023123858 Detroit 4301045752 11/10/1993 Affairs 1128(a)(1) Velez-Ruiz Wanda Enid Physician 1023123858 West Bloomfield 4301045752 1/17/2009 DCH 8/10/1994 Suspended Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing Summary and Suspension Regualtory Summary 4/17/2015 Affairs Suspension 12/14/2015 MDHHS- OIG Termination Verbovsky John R Physician 1528171774 Southfield 5101006690 3/10/2015 DCH-OIG 05/19/2016 HHS-OIG Excluded Vernia Dawn Home Help Battle Creek 2/8/2016 MDHHS Villarta Antonio Q. Physician Adrian 4301033470 2/20/2001 HHS 1128(b)(4) Vineyard Robert Home Help Saginaw 6/29/2017 MDHHS
MI-Licensing and Regulatory Terminated Vivano David Physician 1508816539 Birmingham 4301060296 2/20/2020 MDHHS-OIG 3/2/2020 Affairs Suspended David Viviano MD Orthopaedic Surgery LLC Viviano David Group 1710219407 Troy 2/20/2020 MDHHS-OIG Terminated Vlcko Peter B. Physician Oak Park 5101009612 6/4/1995 HHS 1128(a)(2) Vock Kellie Home Help Grayling 6/6/2018 MDHHS Vogel Peter Home Help Dimondale 12/5/2017 MDHHS
MI-Licensing and Excluded Regulatory Voluntarily Vora Kandarp K Physician 1023119898 Gladwin 4301037407 1/20/2016 Affairs 11/30/2016 HHS-OIG Surrendered
MI-Licensing and Regulatory Voluntarily Vorhies Paul E CRNA 1740246578 Scottville 4704103969 11/8/2012 Affairs Surrendered Wade Doreen Home Help Eastpointe 9/26/2019 MDHHS Wagner Gwendolyn Home Help Detroit 11/30/2015 MDHHS Disiciplinary Limited Wagner Jack W Physician 1588694004 Midland 4301041291 6/26/2018 MDHHS License
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Wagner John R Physician 1396737086 Warren 4301061192 7/13/2012 Affairs 3/27/2013 Affairs Suspended Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Wagoner Eddie Home Help Detroit 6/21/2018 MDHHS Waldron Teddi Irene Home Help Jackson 4/14/2015 DCH Walker Adrian Home Help Inkster 2/17/2016 MDHHS Walker Armond Home Help Farmington Hills 4/17/2018 MDHHS Walker Corey Home Help Detroit 12/17/2019 MDHHS Walker Cory Home Help Westland 3/8/2018 MDHHS Walker LaShawandra Home Help Muskegon 1/6/2016 MDHHS Walker Latonya Home Help Detroit 5/13/2015 DCH MI- Licensing and Summary Regulatory Suspenion Walker Mark Physician 1306819321 Marshall 4301056472 1/15/2020 MDHHS-OIG Affairs Suspended Summary Walker Susan Home Help Warren 6/8/2020 MDHHS-OIG Suspension Walker Tangia Home Help Detroit 1/13/2016 MDHHS Summary Walker Wallace Dentist 1780712109 Okemos 2901012881 7/6/2016 MDHHS-OIG Suspension Wallace Debra Home Help Detroit 4/10/2019 MDHHS Wallace Diamond Home Help Lansing 6/8/2016 MDHHS Wallace Julius Home Help Wayne 4/6/2020 MDHHS Suspended Victor Smith Home Walls Annie Home Help Ypsilanti 1/24/2018 MDHHS-OIG 4/10/2020 MDHHS-OIG Terminated Walls Quintina Home Help Detroit 6/10/2020 MDHHS Walmsley Michael Home Help Oscoda 5/21/2020 MDHHS Walters Angela Home Help Ropgers City 5/11/2021 MDHHS Walton Delois Home Help fraser 8/15/2019 MDHHS 09/05/2002 Violation of Medicaid False Claim Act 09/19/2002 Dr. Waltz Denture Service Waltz Robert I. Dental Group Beaverton 2901006537 9/5/2002 DCH 9/19/2002 HHS 1128(a)(1) Ward Thomas Home Help Warren 5/8/2018 MDHHS Ward-Robinson Jamal Home Help Detroit 4/11/2019 MDHHS Wares Robert Home Help Dowagiac 10/3/2019 MDHHS Terminated Warren Eric Home Help Detroit 2/14/2018 MDHHS Warren Linda F. Home Help Detroit 11/30/2015 MDHHS Warren Misty Home Help Detroit 6/26/2017 MDHHS Warrens Shareese Home Help Grand Rapids 11/19/2016 MDHHS 5/12/2021 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Washingotn Meosha Ho,me Help South Haven 9/10/2019 MDHHS-OIG Washington Alonzo Home Help Lansing 11/14/2017 MDHHS Washington Anthony Home Help Ecorse 12/4/2014 DCH Washington Antwone Home Help Detroit 3/13/2017 MDHHS Washington Ervin Home Help Saginaw 11/24/2014 DCH Washington Herman L Home Help Hesperia 3/5/2015 DCH Summary Washington Jaime Home Help Kalamazoo 9/2/2020 MDHHS-OIG Suspension Washington Joyce Home Help Mount Morris 7/19/2021 MDHHS Washington- Williams Valarie Home Help Lexington, KY 8/20/2018 HHS-OIG Summary Wasnich Tricia Home Help Miidland 4/8/2020 MDHHS-OIG Suspension Watkins Kelli Home Help Detroit 10/24/2016 MDHHS Watkins Shannon Home Help Muskegon 8/27/2015 MDHHS Summary Watkins-Smith Ayanna Home Help Vassar 6/12/2019 MDHHS-OIG Suspension Watson Linda Home Help Port Huron 11/17/2016 MDHHS Watson Paula Home Help Midland 10/13/2017 MDHHS Watson Shon Home Help Muskegon 5/7/2020 MDHHS Watts Alonzo Home Help Detroit 1/25/2016 MDHHS Watts Eddie Home Help Detroit 11/5/2018 MDHHS Violation of Medicaid False Claim Watts Samuel G. Physician Detroit 4301030543 3/18/1987 DCH Act Watts Tamica Home Help Detroit 9/25/2019 MDHHS Watts Tyric Home Help Lansing 11/12/2019 MDHHS
Wayne Ethan Summary Wayne H. Hamilton Palm Beach Gardens 10D2092502 Suspension SMART Lab LLC Wayne Justin Laboratory 1770980062 FL (CLIA) 1/8/2019 MDHHS-OIG 2/7/2019 MDHHS-OIG Terminated Weatherspoon Derick Home Help Flint 12/17/2014 DCH
Summary Weaver David Physician 1720067606 Farmington Hills 5101008321 1/18/2021 MDHHS-OIG Suspensiom Weaver Latonya Home Help Pontiac 8/23/2016 MDHHS Webber Barbra Home Help Grand Rapids 11/15/2018 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason
MI-Licensing and Regulatory Wehr Barbara Valutis Dentist 1700917762 Dexter 2901011361 2/5/2009 Affairs Suspended
MI-Licensing and Regulatory Weinblatt Howard B Physician 1760450191 Ann Arbor 4301037809 5/17/2012 Affairs Suspended
MI-Licensing and Regulatory Weiner Samuel Dentist 1326100611 Huntington Woods 2901007772 12/13/2009 Affairs Suspended Weisenfeld Michael S. Physician Marshall 4301029508 6/18/1998 HHS 1128(a)(1)
HHS DCH MI-Licensing Summary and Suspended 8/20/2017 Regulatory Excluded 10/16/2017 Affairs Revoked Weiss Michael D Physician 1376596726 Southfield 5101007574 8/29/2016 MDHHS-OIG 12/21/2018 MDHHS-OIG Termianted Welch Chante Home Help Saginaw 11/22/2016 MDHHS Welford Eduardo Home Help Comstock Park 3/16/2020 MDHHS Summary Wells Eden Physician 1124394663 Ann Arbor 4301080277 3/8/2021 MDHHS-OIG Suspension Wells Michael Home Help Farwell 5/15/2019 MDHHS Wells Tanesha Home Help Detroit 4/19/2018 MDHHS
MI-Licensing and Regulatory Voluntarily Wenger William Social Worker 1710993886 Kalamazoo 6801019406 2/26/2019 Affairs Surrendered Wesley Jake Home Help Detroit 5/8/2015 DCH Wessels David Home Help Harbor Beach 11/30/2015 MDHHS West Alex Podiatrist 1619165412 Dearborn Heights 5901001051 9/19/2003 HHS 1128(a)(3) West Keith A. Dentist 1598805798 Wyandotte 2901012345 10/20/2004 HHS 1128(a)(3) West Latasha Home Help Kalamazoo 8/23/2018 MDHHS West-Ware Keela Home Help Battle Creek 6/30/2015 DCH Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Whaley Robert Home Help Benton Harbor 9/3/2019 MDHHS Wheaton Rudolph D. Dentist Flint 2901011646 8/6/1997 HHS 1128(b)(4) Wheeler Shannon Home Help Pontiac 2/22/2016 MDHHS Summary Suspension C & M Compassionate Care PLLC Whitaker Christinia Group 1760881726 Coldwater 9/4/2018 MDHHS-OIG 10/4/2018 MDHHS-OIG Terminated Whitaker Jelekeco Home Help Detroit 9/14/2016 MDHHS Whitby Milton Home Help Wyoming 10/18/2014 DCH White Bernard Torrell Home Help Detroit 11/30/2015 MDHHS White Brian Home Help Redford 12/13/2016 MDHHS Summary White Christine Home Help Detroit 5/12/2020 MDHHS-OIG Suspended White Dana Home Help Niles 6/11/2018 MDHHS 10/8/1999 Violation of Medicaid False Claim Act 10/20/2002 White Daniel D. Dentist Grand Rapids 2901011156 10/8/1999 DCH 10/20/2002 HHS 1128(a)(1)
MI-Licensing and Regulatory License White John Arthur Dentist 1407066244 Detroit 2901012365 1/11/2008 Affairs Suspended White Lamount Home Help Detroit 10/19/2016 MDHHS White Mitchell Home Help River Rouge 3/14/2016 MDHHS White Renee Home Help Detroit 12/29/2015 MDHHS White Shamika Home Help Detroit 9/20/2018 MDHHS White Vandalyn Home Help Detroit 1/11/2021 MDHHS White Raymond Home Help Lansing 11/27/2017 MDHHS
Whitemore Ronald Home Help Commerce Township 9/22/2015 MDHHS Whiteside Magalena Home Help Muskegon 3/20/2017 MDHHS
MI-Licensing Summary and Suspension Regulatory Summary 10/23/2015 Afairs Suspension 12/14/2015 MDHHS-OIG Terminated Whiteus Timothy Physician 1174543342 Detroit 4301406556 7/30/2014 DCH-OIG 01/20/2016 HHS-OIG Excluded Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Whitfield Jacqueline Home Help Davison 5/15/2019 MDHHS Whitley Varnell Home Help Grand Rapids 1/12/2017 MDHHS Wible Richard Home Help Muskegon 1/27/2021 MDHHS Wicker Yondina Home Help Saginaw 4/16/2018 MDHHS Summary Suspension East Michigan Family Care Wiggins Shannon Group 1508875840 Lansing 9/30/2013 DCH-OIG 4/15/2014 DCH-OiIG Terminated Summary DCH Suspension East Michigan Family Care PLLC Wiggins Shannon Group 1124135116 Lansing 9/30/2013 HHS 4/15/2014 DCH-OIG Terminated
Wiktor Ralp Physician 1285674044 Grosse Pointe Park 5601003281 8/20/2021 HHS Revoked Summary Suspension Wiggins Shannon Georgean Physician 1295744530 Lansing 5101013727 9/30/2013 DCH 4/15/2014 DCH-OIG Terminated Wilcox Carl Home Help Madison Heights 5/3/2017 MDHHS Wiley Kenneth Home Help Detroit 8/9/2018 MDHHS Summary Suspension Wiley Tia Home Help Detroit 11/19/2018 MDHHS-OIG 12/19/2018 MDHHS-OIG Terminated Williams Belinda Home Help Detroit 9/15/2015 MDHHS
Williams Benshamiel Home Help Detroit 1/18/2017 MDHHS Williams Craig Home Help detroit 10/4/2017 MDHHS Williams Damron Michael Home Help Detroit 11/3/2014 DCH Williams Dannel Home Help Detroit 7/11/2019 MDHHS Non-Emergency Williams Derek Transportation Idlewild 4/6/2017 MDHHS Williams Derrell Home Help Clinton Township 9/20/2018 MDHHS Williams James Home Help Saginaw 10/28/2016 MDHHS Williams Javone Home Help Southfield 6/2/2021 MDHHS Williams John T. Home Help Marion 11/12/2014 DCH Williams Kapone Home Help Lansing 2/18/2016 MDHHS Williams Laverne Home Help Detroit 6/28/2021 MDHS Williams Laquan Home Help Norton Shores 2/14/2019 MDHHS Williams Marcus Home Help Lansing 10/3/2019 MDHHS Williams Melvin Home Help Detroit 2/5/2019 MDHHS Summary Suspension Williams Monita Home Help Detroit 7/23/2019 MDHHS-OIG 8/22/2019 MDHHS-OIG Terminated Williams Montele Home Help Saginaw 8/16/2021 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Blessed Dayz Adult Day Program Summary Inc Williams Nicole Medical Group 1255602793 Westland 1/29/2020 MDHHS-OIG Suspension Williams Ollie Home Help Grand rapids 9/10/2019 MDHHS Williams Owina Home Help Detroit 11/30/2015 MDHHS Williams Rasheedah Home Help Detroit 10/1/2019 MDHHS Williams Raulow Home Help Pontiac 12/6/2018 MDHHS Williams Sammie Home Help Detroit 1/14/2020 MDHHS Williams Sean Home Help Saginaw 2/5/2020 MDHHS Williams Sean Home Help Detroit 12/10/2020 MDHHS Williams Terina Home Help Detroit 9/16/2015 MDHHS Williams Tywone Home Help Detroit 11/21/2019 MDHHS Terminated Williams Veronica Home Help Bay CIty 6/11/2018 MDHHS Williams Victor L Home Help Detroit 9/16/2021 MDHHS Williams William Home Help Detroit 9/7/2017 MDHHS Williams Willie Home Help Inkster 11/3/2017 MDHHS Williams Felicia Home Help Ludington 3/16/2015 DCH Williams Joey Home Help Flint 4/28/2016 MDHHS DCH-OIG Suspended Williamson Paula E Physician 1275588873 Warren 4301041206 7/3/2013 HHS- OIG 4/19/2015 Excluded Willis-Pitts Fred Lee Home Help Detroit 2/27/2015 DCH
MI-Licensing and Regulatory Summary WIlson Alan N Physician 1629029004 Lincoln Park 4301031392 8/4/2016 Affairs Suspension Wilson Carlos Home Help Inkster 6/25/2018 MDHHS Wilson Clarence W. Physician Flint 5101004539 9/2/1997 HHS 1128(b)(3) Wilson Ieisha Home Help Grand Rapids 1/26/2021 MDHHS Wilson Jonathan Home Help Detroit 11/30/2015 MDHHS Wilson Kim Home Help Detroit 8/28/2018 MDHHS Wilson Mardell Home Help Inkster 12/20/2016 MDHHS Wilson Martez Home Help Detroit 11/30/2017 MDHHS Summary MI-Licensing Suspension and Summary 7/13/2016 Regualtory Suspension 12/21/16 Affairs Suspended Wilson Sebastian T Chiropractor 1093773343 Coldwater 2301008079 4/29/2015 DCH-OIG 9/26/2018 MDHHS-OIG Terminated Summary Orthopedic Medical Building Inc. Winchester Iris Medical Group 1154679587 Oak Park 9/25/2018 MDHHS-OIG Suspension Windham Perrien Home Help Dertroit 12/13/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Wingfield James Home Help Battle Creek 6/7/2021 MDHHS
MI-Licensing and Certified Nurse Regulatory Winkler Clarice A Midwife 1457344426 Lansing 4704120674 9/13/2013 Affairs Suspended
Winter Christopher Home Help Kalamazoo 6/6/2019 MDHHS Summary Med One Mobile LLC Wireman Gregory Medical Group 1982076550 Knox, Indiana 1/19/2021 MDHHS-OIG Suspension Witcher Harvell Home Help Detroit 3/20/2017 MDHHS Suspended 1/20/2013 HHS T erminated Witt Kevin Sterling Physician 1619996220 Lansing 5101012167 2/22/2012 DCH 08/07/2013 DCH Suspended Wittmus David Home Help Saginaw 4/7/2016 MDHHS
MI-Licensing MI-Licensing and and Summary Regulatory Regulatory Suspension Wolf Anthony Physician 1033233838 Ann Arbor 4301085709 5/18/2018 Affairs 10/12/2018 Affairs Suspended
MI-Licensing MI-Licensing and and Regulatory Regulatory Wolin Jessica A Physician 1881735173 Muskegon 4301030663 2/13/2020 Affairs 7/15/2020 Affairs Suspended Woodard Charles Home Help Lansing 11/5/2018 MDHHS
MI-Licensing MI-Bureau of and Licensing and Summary Regulatory Regulatory Suspension Woodburn Jack Counselor 1306009196 Port Huron 6401000326 2/21/2020 Affairs 5/14/2020 Affairs Revoked Woodring Travis Home Help Ludington 11/14/2019 MDHHS Woodruff Shawn Home Help Deckerville 8/14/2017 MDHHS Woods David Wayne Home Help Detroit 11/13/2014 DCH Summary Woods Glanda Home Help Dearborn Heights 1/11/2021 MDHHS-OIG Suspension Woods Kenneth Home Help Detroit 4/7/2021 MDHHS Woods Lasonia Home Help Detroit 9/17/2019 MDHHS Woollams Stanley J. Physician Ann Arbor 4301023228 5/6/1996 HHS 1128(b)(4) Wooten Marquet Home Help Grand Rapids 3/30/2017 MDHHS Worth Lori Home Help Evart 7/18/2019 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Wright Darrin Home Help Detroit 11/17/2016 MDHHS Wright Ebony Home Help Detroit 6/16/2020 MDHHS-OIG 6/16/2020 Wright Jessica Home Help Wyoming 6/25/2018 MDHHS Wright Johnny E Home Help Grand Rapids 11/30/2015 MDHHS Wright Larry Home Help Detroit 12/26/2015 MDHHS Wright Priscilla Home Help Detroit 12/4/2018 MDHHS Wright Stacy Home Help Detroit 9/6/2016 MDHHS
Summary Suspension Wright Susan Nurse Practitioner 1720063431 Paw Paw 4704098998 6/8/2020 MDHHS-OIG 1/19/2021 MDHHS-OIG Termination Wyatt Kimberly Home Help Wilson 6/21/2016 MDHHS Summary Believe Home Care LLC Xiong Vai Home Help lansing 10/16/2018 MDHHS-OIG Suspension Yancer Mandy Home Help Coleman 3/27/2017 MDHHS Yancy Damian Home help Saginaw 8/17/2015 MDHHS Yarbrough Tanzer Home Help Detroit 11/7/2018 MDHHS Summary Yasin Fares Physician 1255427472 Dearborn 4301087049 7/11/2018 MDHHS-OIG Suspension Summary Detroit Visiting Physicians PLLC Yasin Faris Medical Group 1801085022 Dearborn 7/11/2018 MDHHS-OIG Suspension Michigan Home Visiting Summary Physicians PC Yasin Faris Group 1346419223 Dearborn 7/11/2018 MDHHS-OIG Suspension Summary YAsin Nura Physician 1265518567 Canton 4301092485 3/4/2020 MDHHS-OIG Suspension Yearling Anthony Home Help Vicksburg 10/17/2017 MDHHS Yeo Judith Home Help Grand Rapids 11/30/2017 MDHHS
MI-Licensing and Regulatory Summary York Aaron Physician 1790040251 Farmington 5151012457 10/16/2020 Affairs Suspension Youhan Randy Home Help West Bloomfield 5/12/2016 MDHHS Young Arstell Home Help Warren 1/30/2015 DCH Summary Conrad- Suspension Young George Spencer Chiropractor 1902953326 Munising 2301008758 3/1/2014 DCH-OIG 12/18/2014 HHS Excluded Young Ida Home Help Standish 6/21/2016 MDHHS Medicaid Michigan Sanction Provider List September 20, 2021 [email protected] Middle Sanction Sanction Sanction Sanction Entity Name Last Name First Name Name Provider Category NPI# City License# Date1 Source Date2 Source Reason Summary MDHHS-OIG Suspension MI-Licensing Terminated 12/26/2018 and Summary 12/12/2018 Regulatory Suspension 5/20/2019 Affairs Revoked Young Lawrence Podiatrist 1881664498 Dearborn 5901000652 12/3/2017 MDHHS-OIG 6/20/2019 HHS-OIG Terminated Young Michael Home Help Detroit 11/18/2014 DCH Young Randy Home Help Vandalia 6/21/2018 MDHHS
MI-Licensing and Regulatory Yousif Layla R Dentist 1831309228 Shelby Township 2901017121 2/19/2015 Affairs Suspended Summary Yufa Irina Home Help West Bloomfield 1/11/2021 MDHHS-OIG Suspension Controlled Substance MI-Licensing license and suspended Regulatory Summary Seaway Pharmacy Zaher Hani Pharmacy 1457525818 Taylor 5301008838 5/10/2018 Affairs 6/13/2018 MDHHS-OIG Suspension Summary Zahoor Mohammad Physician 1922096452 Novi 4301062300 10/15/2017 MDHHS-OIG Suspension Zaragoza Carlos Home Help Saginaw 11/30/2015 MDHHS Zeliasko Steven David Home Help Indian River 11/13/2014 DCH
MI-Licensing and Regulatory Zerby Kristin Pharmacist 1497249569 Mackinac 5315110839 2/19/2020 Affairs Suspended
MI-Licensing and Regulatory Zieger Harvey Physician 1528050267 Detroit 5101006597 3/24/2015 Affairs Suspended Zimmerman Katherine Home Help Mt. Pleasant 9/23/2015 MDHHS