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Deactivated NPI 1013427913 Deactivated / Inactive NPI Male Practitioner

Michael E Brokaw

Peer Specialist • Canton, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Michael Brokaw has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 05, 2017
NPI Deactivation Date October 28, 2019
Total Practice Duration ~2 Years of Practice (2017 – 2019)

Professional Overview & Biography Verified Profile Summary

Michael Brokaw was a registered Peer Specialist practicing in Canton, MI. Throughout an active medical career spanning 2 years, Michael Brokaw provided care at the practice location at 43825 MICHIGAN AVE STE 2 until profile deactivation on 2019-10-28.

Practice Location & Contact Primary Location

Practice Address

43825 Michigan Ave Ste 2

Canton, MI 481882551

Telephone 7347130088
Fax 7343985618
Associated Practice Facility / Clinic
🏢 Hegira Health, Inc. Facility NPI 1902082605

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Canton, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
44 Specialists

Practicing in Canton, MI (1765 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Brandy Chappell , LPN

Licensed Practical Nurse

NPI 1144855115

Licensed Practical Nurse

Telane Hadden , RN, BSN

Registered Nurse

NPI 1184451346

Registered Nurse, Bachelor of Science in Nursing

NPI 1215256821

Licensed Limited Psychologist

Helen Wojey , LPN

Licensed Practical Nurse

NPI 1609305317

Licensed Practical Nurse

Constance Joyner , RN

Registered Nurse

NPI 1679934046

Registered Nurse

Lenora Boyer

Licensed Practical Nurse

NPI 1922421114

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated October 28, 2019

Record deactivated on October 28, 2019

NPI Profile Active October 05, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location October 05, 2017

Registered at 43825 MICHIGAN AVE STE 2, CANTON, MI 481882551 (Tel: 7347130088)

📍
Updated Business Mailing Address October 05, 2017

Registered at 37450 SCHOOLCRAFT RD STE 110, LIVONIA, MI 481501000 (Tel: 7344584601)

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Provider Name / Credentials Updated October 05, 2017

Recorded as MICHAEL BROKAW

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 05, 2017

Peer Specialist

🟢
Initial NPI Registration & Enumeration October 05, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013427913
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 05, 2017
Last Update: October 05, 2017
Deactivation Date: October 28, 2019

Mailing Address

37450 Schoolcraft Rd Ste 110

Livonia, MI 481501000

Phone: 7344584601

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.