Entity Name Last Name First Name Middle Name Provider Category NPI# City License# Sanction Date1 Sanction Source Sanction Date2 Sanction Source Reason 1st Priority Physical Therapy LLC Group 1134422363 Detroit 8/2/2016 MDHHS-OIG Summary Suspension AGSS Properties LLC Home Help Agency Ann Arbor 8/29/2017 MDHHS 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) A Place Called Home Goree Jimmie Non Emergency Transportation Detroit 6/1/2017 MDHHS Abyssinia Love Knot Physical Therapy LLC Medical Group 1255667556 Southfield 8/3/2016 MDHHS-OIG Summary Supension Absolute Apothecary Pharmacy/Medic al Supplier Detroit 5301004065 5/24/1994 HHS 1128(b)(3) Absolute Prescription Center Pharmacy/Medic al Supplier Detroit 5301004594 5/23/1994 HHS 1128(b)(3) Advanced Care Services Group 1811290794 Oak Park 12/22/2015 HHS Summary Suspension Advanced Homecare Pharmacy Pharmacy 1710923107 Redford 5301008284 10/14/2015 MI-Licensing and Regulatory Affairs Voluntarily Surrendered Advanced Sleep Neurodiagnotics PC Medical Group 1134143654 Farmington Hills 10/15/2017 MDHHS-OIG Summary Suspension Alam, Waseem MD PC Medical Group 1184724114 Bloomfield Hills 7/29/2015 Summary Suspension Medicaid Michigan Sanction Provider List April 25, 2018 To confirm an sanction name match please email [email protected]
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Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
1st Priority Physical Therapy LLC Group 1134422363 Detroit 8/2/2016 MDHHS-OIG
Summary Suspension
AGSS Properties LLC
Home Help Agency Ann Arbor 8/29/2017 MDHHS
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)A Place Called Home Goree Jimmie
Non Emergency Transportation Detroit 6/1/2017 MDHHS
Abyssinia Love Knot Physical Therapy LLC Medical Group 1255667556 Southfield 8/3/2016 MDHHS-OIG
Summary Supension
Absolute Apothecary
Pharmacy/Medical Supplier Detroit 5301004065 5/24/1994 HHS 1128(b)(3)
Absolute Prescription Center
Pharmacy/Medical Supplier Detroit 5301004594 5/23/1994 HHS 1128(b)(3)
Advanced Care Services Group 1811290794 Oak Park 12/22/2015 HHS
Rehab Therapy Services Detroit 36687 12/18/2003 HHS 1128(a)(1)
BrightSmiles Dental Group 1508229014 West Bloomfield 20153421 1/26/2017 MDHHS TerminatedBrightSmiles PA 161 Dental Group 1083848311 Waterfrd 20152161 1/26/2017 MDHHS TerminatedBroadstreet Nursing Center Nursing Facility 83418 9/27/2000Canton Urgent Care P.C. Group 1992830863 Canton 5/18/2016
Summary Suspension
Cedar Knoll Care Center Nursing Facility Grass Lake 3/7/2007 DCH
License Revocation
Centrad Healthcare LLC Group 1346243979 Naperville, IL 11/14/2017 MDHHS-OIG
Summary Suspension
Certified Air Respiratory Equipment, Inc. (aka CARE, Inc.) Medical Supplier Southfield 7/4/1996 HHS 1128(a)(1)Chiropractic Associates, Inc.
Chiropractic Group Ludington 5/6/1996 HHS 1128(b)(8)
Clinical Psychiatric Medicine PC Group 1386677185 Grandville 7/18/2013 DCH-OIG SuspendedCommerce Township Pharmacy Pharmacy 1851616452
Dearborn Internist P.C. Medical Group 1023314341 Dearborn 3/14/2017 MDHHS-OIG
Summary Suspension
Dearborn Pharmacy, Inc. Pharmacy Dearborn 2/20/2006 HHS 1128(a)(3)Dearborn Podiatric Surgeons PC Group 1447467485 Dearborn 12/3/2017 MDHHS-OIG
Summary Suspension
Dearborn Nuro Clinic PC Group 1568638088 Dearborn 12/1/2016 MDHHS-OIG 4/12/2018 MDHHS-OIG
Summary Suspension Terminated
Dearborn Rx Pharmacy Group 1982054383 Dearborn 7/26/2017
MI-Licensing and Regulatory Affairs 12/13/2017
MI-Licensing and Regulatory Affairs
Summary Suspension Voluntary Termination
Dental Health Care Clinics, Inc. Dental Group Detroit 4/11/1995 HHS 1128(a)(1)Detroit Diverse Care, Inc. Physician Group Detroit 3/16/1997 HHS 1128(a)(1)Detroit Medical Clinic Medical Group 1245244110 Detroit 7/30/2013 DCH-OIG
Summary Suspension
Diamond Pharmacy Pharmacy 1720380140 Kalamazoo
NCPDP 2374724 8/19/2011 DCH 6/2/2016 MDHHS
Summary Suspension Termination
Downriver Medical Associates PLC Physician Group 1114055811 Monroe 3/21/2013 DCH 3/21/2013 DCH
Summary Suspension Termination
Durand Clinic PC Physician Group Durand 9/20/2001 HHS 1128(a)(3)Dwight E. Smith MD PC Physician Group 1003849753 Detroit 5/29/2012 DCH
Summary Suspension
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
East Village Pharmacy Pharmacy 1982928818 Dearborn 8/29/2016 MDHHS-OIG
Summary Suspension
EB James Nursing Center Nursing Facility Detroit 83422 2/12/2002
MI-Licensing and Regulatory Affairs
License revocation and summary suspension
Elrington Medical Center PLLC
Medical Supply Company 1205875697 Redford 10/22/2013 DCH-OIG
Summary Suspension
Elrose Health Services, Inc. SA Treatment Detroit 21431 4/17/1995
MI-Licensing and Regulatory Affairs 10/20/1998 HHS
10/20/98: 1128(a)(1)
Elrose Health Services, Inc. SA Treatment Detroit 21391 4/17/1995
MI-Licensing and Regulatory Affairs 10/20/1998 HHS
10/20/98: 1128(a)(1)
Elrose Health Services, Inc. SA Treatment Detroit 20731 4/17/1995
MI-Licensing and Regulatory Affairs 10/20/1998 HHS
10/20/98: 1128(a)(1)
Emergency Medical Clinic, Inc. Physician Group Hamtramck 12/23/1991 HHS 1128(a)(1)Enjoy Dental Care PC Dental Group Detroit 5/20/2004 HHS 1128(a)(1)Excellent Kare Home Agency for Michigan Knight Eugene Home Help Detroit 10/27/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
LaSalle Nursing Home Nursing Facility Detroit 83453 11/14/2003
MI-Licensing and Regulatory Affairs
License Revocation and decertification
Lexington Pharmacy Pharmacy Detroit 5301000141 6/27/1991 HHS 1128(b)(4)Liberty Express Care Group 1508066036 Saginaw 12/5/2016 MDHHS-OIG 2/9/2017
Summary Suspension
Litchfield Nursing Centre Nursing Facility Litchfield 5/4/2007 HHS DecertificationLiteMed Rx Inc Pharmacy 1457774366 Garden City 5301010314 2/4/2017 HHS RevokedLittle Traverse Bay Family Medicine Group 1417136425 Petosky 3/16/2015 DCH-OIG Terminated
Livernois Family Medical Service Group 1417985441 Livernois 4/6/2015 DCH-OIG 6/2/2016 MDHHS-OIG
Summary Suspension Termination
Livernois Family Pharmacy Pharmacy 1790866416 Detroit 5301007422 8/26/2014 DCH-OIG SuspendedLivestrong Pharmacy Pharmacy 1275925950 Detroit 12/25/2017 MDHHS-OIG
Summary Suspension
Livonia Care Pharmacy Pharmacy 1942560529 Livonia 5301009802 1/24/2018 MDHHS-OIG
Summary Suspension
Love Covers All MIHP MIHP 1548566334 Grosse Pointe Park 10/19/2016 MDHHS-OIG
Summary Suspension
Macomb Professional Lab, Inc Laboratory Sterling Heights 8/18/1988 HHS 1128(a)(1)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Madison Pharmacy Inc Pharmacy 1790961118 Madison Heights 5301009979 8/9/2017
MI- Licensing and Regulatory Affairs
Volunatarily Surrendered
Mancewicz & White DDS, PC Dental Group Grand Rapids 6/20/2002 HHS 1128(a)(1)Med Pharmacy, Inc. Pharmacy Ypsilanti 5301000072 8/19/1988 HHS 1128(b)(3)Medaplex Dental Center Dental Group 1326343542 Oak PArk 1/18/2017 MDHHS-OIG
Summary Suspension
Medicap Pharmacy
Pharmacy/ Medical Supplier Flint 5301006828 10/13/2004
MI-Licensing and Regulatory Affairs Suspended
Metro Home Visiting Physicians PLLC Chang Zongli Group 1730373440 Livonia 3/27/2018 MDHHS-OIG
Summary Suspension
Metro Mobile Physicians Group 1962704239 Ferndale 7/13/2016 MDHHS-OIG
Summary Suspension
Metro Pharmacy Pharmacy Detroit 5301003024 2/7/1994 HHS 1128(a)(1)Michgan Brain and Spine Ohysicians Group, PLLC Group 1760771117 Southfield 3/10/2015 DCH-OIG 4/26/2017 MDHHS-OIG
Summary Suspension Terminated
Midwest Family Diagnostics PLC Group 1184952053 Warren 7/3/2013 DCH-OIG 5/5/2016 MDHHS-OIG
Suspended Terminated
Midwest Family Practice PLC Group 1770819864 Warren 7/3/2013 DCH-OIG 5/5/2016 MDHHS-OIG
Summary Suspension Terminated
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Neuhoff Drugs, Inc. Pharmacy Detroit 5301004598 8/24/1989 DCH
Violation of Medicaid False Claim Act
Neuhoff Drugs, Inc. Group Detroit 5301004058 8/24/1989 DCH
Violation of Medicaid False Claim Act
New Beginning Adult Senior Care Center Group 1124431580 Livonia 7/25/2016 MDHHS-OIG
Summary Suspension
New Center Medical PC Group 1316482870 Detroit 12/18/2017 MDHHS-OIG
Summary Suspension
New Era Alternative Treatment Center, Inc. (NEAT) SA Treatment Highland Park 21310 9/20/2001 HHSNew Era Alternative Treatment Center, Inc. (NEAT) SA Treatment Flint 50219 9/20/2001 HHSNorthside Medical Clinic PC Group 1841357464 Cheboygan 4/4/2016 MDHS-OIG
Summary Suspension
Northwest Industrial & Medical Services PC Group 1346364619 Detroit 7/3/2013 DCH-OIG Suspended
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
SKA at Home Visting Doctor PC Group 1043507379 Albion 7/3/2013 DCH-OIG 0/12/2016 MDHHS-OIG
Suspended Terminated
Soliman Medical Center PLLC Group 1952503559 Wayne 7/3/2013 DCH-OIG SuspendedSoliman Medical Center PLLC Group 1619946043 Wayne 7/3/2013 DCH-OIG Suspended
Southwest Visiting Physicians Group 1881868685 Warren 12/29/2015 MDHHS TerminatedTaylor Medical and Substance Abuse Clinic Group 1386974335 Taylor 7/3/2013 DCH-OIG 4/15/2014 DCH-OIG
Suspended/ Terminated
Tower Dental Care Group 1306019609 Detroit 2/18/2010 HHS 1128(b)(8)
Tri County Physician Group Group 1386942035 Detroit 2/7/2017 MDHHS-OIG 12/18/2017 MDHHS-OIG
Summary Suspension Summary Suspension
Tri State Physicians Group PC Group 1033654595 Detroit 11/12/2017 MDHHS-OIG
Summary Suspension
Trust Care Clinic PLLC Group 1053461848 Davison 6/18/2015 DCH-OIG SuspendedUnarex of Lincoln Park, Inc. Pharmacy Lincoln Park 5301000166 9/5/1988 HHS 1128(b)(3)Universal Home Medical Equipment & Supplies LLC Supplier 1730334939 Livonia 4/26/2016 CMS Revoked
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Venoy Nursing Center Nursing Facility Wayne 5/6/1998
MI-Licensing and Regulatory Affairs
Licensing Revocation and Summary Suspension
Village Pharmacy Pharmacy Southfield 5301003265 7/28/1988 HHS 1128(a)(1)Visiting Doctors of America PC Group 1659519981 Southfield 7/30/2013 DCH-OIG Suspended
W.D. Lee Center for Life Management, Inc. SA Treatment Detroit 21242 4/18/2002 HHS
Waldrake Pharmacy, Inc. Pharmacy West Bloomfield 5301004125 8/19/1988 DCH
Revoked/Violation of Medicaid False Claim Act
Wayne Pharmacy Pharmacy 1235437807 Detroit 8/30/2011 DCH 7/11/2016 MDHHS-OIG
Summary Suspension Termination
Washington Blvd. Dental PC Dental Group Detroit 8/31/2007 HHS 1128(a)(1)Weiner & Belkin DDS, PC Dental Group Detroit 2/8/1994 HHS 1128(a)(1)
White Oak Manor Nursing Facility Mio 68402 1/13/1999
MI-Licensing and Regulatory Affairs Decertification
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Woodward Nursing Center Nursing Facility Detroit 9/20/2004
MI-Licensing and Regulatory Affairs
Involuntary Termination
Woodward Urgent Care PLLC Medical Group 1861746893 Detroit 7/28/2015 MDHHS-OIG
Summary Suspension
World Health Care MC LLC Group 1952565160 Detroit 3/21/2013 DCH
Summary Suspension
Zagerman Enterprises, Inc. Group GrandVille 10/19/2005 DCH-OIG Suspended
Aagesen Larry K Dentist 1063572667 Bad Axe 2901009390 7/13/2013
MI-Licensing and Regulatory Affairs Suspended
Abcumby Keshuna Home Help Auburn Hills 8/21/2017 MDHHS
Ackerman Jr Robert A Physician 1487630075 North Muskegon 4301077358 5/18/2016
MI-Licensing and Regulatory Affairs
Summary Suspension
Adams Amy Home Help Mount Morris 6/24/2015 DCHAdams Angela Home Help Detroit 7/24/2017 MDHHSAdams Donald Lee Home Help Benton Harbor 11/30/2015 MDHHSAdams Jamal Home Help Detroit 7/6/2017 MDHHS
Addison ReginaldNon-Emergency Transportation Detroit 12/12/2017 MDHHS
Adray Allie A. Chiropractor Dearborn 2301006500 7/4/1996 DCH-OIG 1128(b)(14)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Alt William J Physician- 1912998337 Holland 4301020997 7/18/2013 DCH-OIG1/20/2016 12/29/2016
MI-Licensing and Regulatory Affairs HHS-OIG
Suspended Suspended Terminated
Altantawi Bassel Physician 1497797526 Canton 4301074111 6/20/2016 MDHHS-OIG2/9/2017 08/20/2017
MI-Licensing and Regulatory Affairs HHS
Summary Suspension Summmary Suspension Excluded
Alyas Arkan Home Help Sterling Heights 4/11/2016 MDHHSAmerson Kevin Home Help Detroit 5/27/2015 DCH
Amin Mohammad N Physician 1083612840 Bloomfield Hills 4301048260 5/13/2015 DCH-OIG
Summary Suspension Terminated
U.S. Medical Supply, Inc. Amr Hussein M. Medical Supplier Livonia 11/5/2002 DCH 9/20/2004 HHS
11/5/02: Violation of Medicaid False Claim Act9/20/04: 1128(a)(1)
Andersen Judith C Physician 1073551198 Rochester 4301044420 6/22/2014
MI-Licensing and Regulatory Affairs Suspended
Anderson Carmen Home Help Benton Harbor 2/8/2016 MDHHSAnderson Connie Home Help Prescott 4/28/2016 MDHHSAnderson Dantonetee Home Help Detroit 9/6/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Anderson Gerald Home Help Detroit 9/21/2017 MDHHSAnderson Julius NEMT Detroit 4/18/2018 MDHHSAnderson Kelvin Lamont Home Help Detroit 3/24/2015 DCHAnderson Maurcie Home Help Detroit 12/28/2016 MDHHSAnderson Paula Home Help Iron Mountain 1/8/2015 DCHAndrews Christian Home Help Detroit 12/6/2017 MDHHSAndrews Glenn Walter Physician Detroit 4301407042 5/26/1997 HHS 1128(b)(4)Andrews Quenta Home Help Grand Rapids 1/19/2016 MDHHSAndrews Wunika Kenyetta Home Help Detroit 11/30/2015 MDHHS
Ansari Inamul Hag Physician Detroit 4301044238 8/29/1993 HHS 10/11/1993 DCH
8/29/93: 1128(a)(1)10/11/93: Violation of Medicaid False Claim Act
Anthony Kirk J Podiatrist 1144330556 Grand Rapids 5901400050 5/25/2013
MI-Licensing and Regulatory Affairs 7/18/2013 DCH-OIG
Suspended Suspended
Anthony Tora Home Help Detroit 11/30/2015 MDHHSAnuskziewicz Michael Home Help Port Huron 10/4/2016 MDHHSAranda Raul E. Physician Detroit 4301038425 3/15/1990 HHS 1128(b)(3)
Araujo MarioNon- Emergency Transportation Holland 7/20/2017 MDHHS
Ayers Antwone Home Help Roseville 2/3/2015 DCHAyoub Ferris Home Help Sterling Heights 1/30/2017 MDHHSBaber DeMarcus Home Help Saginaw 6/23/2016 MDHHSBailey Melvina Home Help New Haven 1/20/2016 MDHHSBaker Carmen Vietta Home Help Detroit 11/30/2015 MDHHSBaker Marques Home Help Kalamazoo 12/19/2016 MDHHSBalakrishna Banga M. Physician Southfield 4301031899 5/18/2000 HHS 1128(a)(1)Baldwin Jr. Milton Home Help Essexville 9/21/2015 MDHHSBallard Carlton Home Help Kalamazoo 4/7/2016 MDHHSBanks Angela A Home Help Jackson 11/30/2015 MDHHSBankston AUDREA Home Help Port Huron 1/14/2016 MDHHS
Bass Bernard A Home Help Detroit 11/30/2015 MDHHSBates Sabrena Home Help D etroit 02/05/218 MDHHSBattle Lashannua S Home Help Detroit 4/27/2015 DCHBayless Jeffrey Home Help Detroit 11/8/2017 MDHHSBaysinger Christopher Home Help Ludington 2/16/2017 MDHHS
Beale, Jr James Physician 1316934409 Southfiled 4301035963 5/22/2016
MI-Licensing and Regulatory Affairs Suspended
Beale, Jr Raymond Home Help Detroit 11/14/2016 MDHHSBean Dominique Home Help Detroit 10/13/2014 DCHBeard Rodney Home Help Detroit 3/23/2015 DCHBeard Tanya HomeHelp Detroit 12/20/2017 MDHHSBearden Michael Home Help Detroit 8/17/2017 MDHHSBearden Tiffany Home Help Roseville 8/28/2017 MDHHSBeasley Jermaine Home Help Belleville 10/5/2017 MDHHSBeasley Rogers Home Help Detroit 10/13/2017 MDHHSBeech Melvin Home Help Grand Rapids 7/27/2016 MDHHSBeecham Paula Home Help Detroit 11/12/2014 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Behnan Richard A Podiatrist 1306924337 Clarkston 5901001092 3/25/2013 DCHSummary Suspension
Bell Deangelo Home Help Flint 11/19/2015 MDHHS
Bell Harry T Dentist 1003985532 Portage 2901016361 8/11/2016
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Bell James E Home Help Benton Harbor 3/23/2015 DCHBellamy Emmanuel Home Help Southfield 1/19/2016 MDHHSBellamy Herbert Home Help Sterling Heights 11/30/2015 MDHHS
Bellinger Thomas M Physician 1457316655 Freeland 4301406493 5/10/2015
MI-Licensing and Regulatory Affairs 5/10/2015
Summary Suspension
Eaton Manor, Inc Benisatto Salvatore D. Nursing Facility Charlotte 7/20/2004 HHS 1128(a)(1)
Inkster Pharmacy Bennett Donald J. Pharmacy Inkster 5301004725 1/24/1994 DCH 8/10/1994
1/24/94: Violation of Medicaid False Claim Act8/10/94: 1128(a)(1)
Bilani Sami Suheil Dentist 1821140187 Hamtramck 290116822 4/12/2001 DCH 9/20/2001
4/12/01: Violation of Medicaid False Claim Act9/20/01: 1128(a)(1)
Bilani, Sami S., DDS, PC (aka Family Dentist PC) Bilani Sami Suheil Dental Group Hamtramck 4/12/2001 DCH 9/20/2001
4/12/01: Violation of Medicaid False Claim Act9/20/01: 1128(a)(1)
First Care Hamtramck Dental PC Bilani Sami Suheil Dental Group Hamtramck 4/12/2001 DCH 9/20/2001
4/12/01: Violation of Medicaid False Claim Act9/20/01: 1128(a)(1)
Billups Sherman Home Help Oak Park 5/22/2017 MDHHS
Bischoff William H. Chiropractor Fenton 2301002126 12/22/1991 HHSLicense Revocation
Bivens Dontae Home Help Detroit 11/14/2016 MDHHSBlack Andrea Home Help Detroit 2/3/2016 MDHHSBlack Arvin D Home Help Dowagiac 3/6/2015 DCHBlack Lawrence Home Help Detroit 5/19/2015 DCHBlack Tasha Home Help Kalamazoo 11/30/2015 MDHHSBlackburn Patricia Ann Home Help Port Huron 6/2/2015 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Blackmon Kariaba Home Help Muskegon 8/11/2015 MDHHSBlair Patrick E Home Help Niagara 2/5/2015 DCHBlakeley Courtney Home Help Grand rapids 8/2/2017 MDHHSBlakney Donald William-Charl Home Help Vermontville 4/10/2015 DCHBlanding Richard L. Dentist 1760665006 Detroit 2901010938 7/3/1988 HHS 1128(a)(1)
Blanzy Edward Anthony Physician 1740332600 Allen Park 5101010788 12/6/2007
MI-Licensing and Regulatory Affairs Suspended
Bledsoe Dayon Home Help Pontiac 3/22/2017 MDHHS
Bobb-Semple HubertPodiatrist/Medical Supplier Highland Park 5901000976 11/12/1990 DCH
Violation of Medicaid False Claim Act
Boggon Taryn Home Help Detroit 6/21/2016 MDHHSBohn Lindsey Home Help Port Huron 2/18/2016 MDHHSBolton Dennis Home Help Dearborn Heights 3/27/2015 DCHBonds Rashimme Omar Home Help Pontiac 11/20/2014 DCHBonner Sirece Home Help Detroit 11/5/2014 DCH
Bosley Crystal Home Help Saginaw 7/18/2016 MDHHS-OIGSummary Suspension
Bossenbery Stephen Physician 1487680302 Grand Rapids 4301087079 7/15/2013
MI-Licensing and Regulatory Affairs Suspended
Botvinick Brad A Physician 1962497719 Detroit 4301089224 10/25/2012
MI-Licensing and Regulatory Affairs Suspended
Bowden Valerie Home Help Detroit 3/30/2015 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Bowers Philip CRNA 1376672527 Huntington woods 4704156709 1/12/2017
MI-Licensing and Regulatory Affairs Suspended
Bowman Daniel Home Help Prescott 3/5/2018 MDHHSBoyd Jermaine Anthony Home Help Kalamazoo 11/30/2015 MDHHSBradford Christopher Home Help Hamtramck 11/14/2017 MDHHSBradley John Wesley Home Help Detroit 12/15/2015 MDHHS Bradley Stewart Home Help Detroit 1/25/2016 MDHHSBrandon Darrall Home Help Kalamazoo 12/15/2015 MDHHSBranham Bradley Willis Chiropractor Coldwater 2301007189 9/20/2001 HHS 1128(a)(3)Brantley Ruth Home Help River Rouge 2/11/2014 DCH-OIG 7/7/2015 MDHHS-OIG TerminatedBraynt Jermaine Home Help Highland Park 7/27/2016 MDHHSBrazil Michael J. Physician Riverview 5101012432 10/19/1996 HHS 1128(a)(1)
Brevitz Linda S Physician 1790897288 Marshall 5101007224 9/21/2017
MI- Licensing and Regulatory Affairs Suspended
Brewer Akeem Olajuwon Home Help Saginaw 1/30/2015 DCHBrewer David Home Help Inkster 4/19/2018 MDHHSBrewer Rosetta Home Help Battle Creek 11/30/2015 MDHHS
Brewster MArk Physician 1275773046 Kalkaska 4301090453 11/27/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Bridgeman Sonya Home Help Benton Harbor 1/26/2015 DCHBritt Claudius Home Help Inkster 3/23/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Britz Joseph Physician 1811004617 Ludington 4301060161 3/12/2011
MI-Licensing and Regulatory Affairs
Suspended, Drug Diversion, Mental/Physical Inability
Broadnax Olivia Home Help Detroit 11/5/2016 MDHHSBrocks Alicia Home Help Muskegon 1/13/2016 MDHHSBrod Jason Stewart Home Help Oak Park 4/28/2015 DCHBrook Reginald Home Help Detroit 4/2/2015 DCHBrooks Dontae HomeHelp Detroit 11/1/2017 MDHHSBrooks John C Home Help Detroit 11/30/2015 MDHHSBrooks Pamela Home Help Reed City 12/28/2016 MDHHSBrooks Sharon Home Help Southfield 3/6/2018 MDHHSBrower Carol T Home Help PawPaw 4/14/2015 DCHBrown Anthony Home Help Detroit 12/17/2015 MDHHSBrown Bertha Home Help Detroit 4/14/2016 MDHHSBrown Carema Home Help Detroit 3/20/2018 MDHHSBrown Charles T Home Help Jackson 11/30/2015 MDHHSBrown Ebony Home Help Detroit 11/16/2015 MDHHSBrown Izell Home Help Detroit 1/19/2017 MDHHSBrown Jaremy Anton Home Help Port Huron 2/5/2015 DCHBrown Kwan Home Help Monroe 12/8/2015 MDHHSBrown Larry Home Help Eastpointe 12/14/2016 MDHHS
Brown Mark A Dentist 1740208172 Madison Heights 2901013422 11/5/2015
MI-Licensing and Regulatory Affairs
Summary Suspension
Brown Randy Home Help Saginaw 7/27/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Buford Keith Home Help Detroit 11/5/2016 MDHHSBunn Scott Home Help Wyoming 9/20/2016 MDHHSBurke Damarcus Home Help Flint 7/26/2016 MDHHSBuckner Billy Joe Home Help Grand Rapids 12/26/2014 DCHBurgin Chandra S Home Help Baldwin 11/30/2015 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Burkes Derrick Ramone Home Help Detroit 11/24/2014 DCHBurleson Lisa Home Help Belleville 11/30/2015 MDHHS
Burman Matthew L. Physician 1427054899 Bloomfield Hills 4301030145 5/2/2009
MI-Licensing and Regulatory Affairs Suspended
Burrell Johnathan Home Help Mount Clemens 1/20/2018 MDHHSBurton Daniel Home Help Delton 12/17/2015 MDHHSBusher Jason Home Help Detroit 6/25/2015 DCHBuszek Robert F. Physician Highland Park 5101006226 10/6/1994 HHS 1128(b)(4)
Butler Dennis A Dentist 1053499475 Southfield 2901011373 1/24/2013
MI-Licensing and Regulatory Affairs Suspended
Butler Donzel Home Help Detroit 10/12/2016 MDHHSButler Earnest Leon Home Help Detroit 1/21/2015 DCH
Butler Koreen Home Help Lincoln Park 10/10/2016 MDHHSButler Tony Eugene Home Help Detroit 4/1/2015 DCH
Byl Danny H. Dentist Potterville 2901013592 8/18/1997 HHS 1128(b)(4)Byrd Antwone Home Help Detroit 11/22/2016 MDHHSCajer Chochon Home Help Detroit 3/23/2017 MDHHSCallahan Keith H. Dentist Flint 2901014674 5/25/1997 HHS 1128(b)(3)
Calhoun-Goddeck Adrienne Home Help Port Huron 1/3/2018 MDHHSCamp Clarence L. Dentist 1649347212 Detroit 2901015197 10/20/1999 HHS 1128(b)(14)Campbell Cavin Home Help Wyandotte 1/21/2017 MDHHSCampbell Steven K. Physician Flint 4301048115 4/10/1991 HHS 1128(b)(4)Campbell Sylvester Home Help Highland Park 3/25/2015 DCH
Capper Bradford G. Physician Detroit 5101006432 9/5/1984 HHS 1128(a)(1)Capriccioso Richard P. Physician Detroit 4301047689 11/11/1992 HHS 1128(a)(2)Carpenter Samantha Home Help Hale 12/8/2015 MDHHSCarrier Nakisia Home Help Detroit 8/17/2016 MDHS
Carrier Shannon Lyn Home Help Harrison Township 3/23/2015 DCH
Carlyon Larry F Physician 1396851366 Ishpeming 4301040361 3/16/2016
Mi-Licensing and Regulatory Affairs
Voluntarily Surrendered
Carter Corey HomeHelp Hazel Park 10/27/2017 MDHHSCarter Gerald Home Help Detroit 3/15/2016 MDHHSCaver Latoya Home Help Detroit 1/6/2016 MDHHS
Castro-Urrutia Fernando Jose Physician 1578580411 Coldwater 4301067134 6/16/2017
MI-Licensing and Regulatory Affairs
Disciplinary Limted License
Castleberry Barbara Home Help Augusta 8/29/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
MI-Licensing and Regulatory Affairs 3/27/2018 MDHHS-OIG
Summary Suspension
Chapman Oneal Home Help Saginaw 11/30/2015 MDHHSCharleston Adam Home Help Kalamazoo 11/30/2015 MDHHSChastang Debra Home Help Detroit 10/10/2016 MDHHSChaverst Javon Home Help Harrison Township 8/23/2017 MDHHSChears Ronald Home Help Detroit 3/20/2015 DCHChears Terrance Benard Home Help Detroit 3/6/2015 DCHCherry Joseph B Home Help Muskegon 11/30/2015 MDHHS
Cheeseman JacquelineNon- Emergency Transpotation DeTour Village 6/19/2017 MDHHS
Chun Kenneth K. Physician 1467511808 Bloomfield Hills 4301038189 9/13/2017
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Chupka Thomas E Dentist 1790011450 Sault Sainte Marie 2901011891 2/21/2013
MI-Licensing and Regulatory Affairs Suspended
Church Aimee Home Help Caro 1/27/2018 MDHHS
Church Kortez Home Help Saint Claire Shores 5/10/2017 MDHHSCiesielski Leonard Home Help Bay City 8/11/2015 MDHHSClark Carla Home Help Grand Rapids 7/14/2016 MDHHSClark Frank L. Physician Petosky 4301042015 7/8/1993 HHS 1128(b)(3)Clark Gregory Home Help Grand Rapids 12/1/2015 MDHHSClark Lawrence Home Help Detroit 12/29/2016 MDHHSClark Valerie Home Help Grand Rapids 5/23/2017 MDHHSClay Gladys Home Help Detroit 2/9/2016 MDHHSClay Jermaine Home Help Detroit 11/12/2016 MDHHSCleveland Genea N Home Help Romulus 11/30/2015 MDHHS
Cloherty Anne F CRNA 1750357885 Farmington Hills 4704195084 3/23/2016
MI-Licensing and Regulatory Affairs 8/4/2016
MI-Licensing and Regulatory Affairs
Summary Suspension Summary Suspension
Cochran Lawrence Home Help Ferndale 4/17/2017 MDHHSCoates Brenda Lee Home Help Benton Harbor 3/30/2015 DCHCoates Richard Home Help Redford 7/13/2017 MDHHS
Cohen Abbott B. Podiatrist Alpena 5901001980 8/19/2004 HHS 1128(a)(4)Cohen Stanley B Podiatrist 1326014358 Detroit 5901001139 2/9/2017 HHS RevokedColbert Marion Home Help Detroit 2/13/2017 MDHHSCole Diana Home Help Coleman 5/8/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Cole EarlNon Emergency Transportation Bay City 1/8/2018 MDHHS
Cole Katrina Home Help Grand Rapids 4/18/2016 MDHHSColeman Donald Home Help Center Lake 9/26/2017 MDHHSColeman Kenneth Home Help Warren 12/2/2016 MDHHSColeman Ray Home Help Lansing 1/13/2016 MDHHS 9/14/2017 MDHHSColeman Richo Home Help Detroit 1/21/2017 MDHHSColes Arturo Home Help Detroit 12/19/2016 MDHHS
Collazo Luis M Physician 1699849885 Fraser 4301062191 7/30/2013 DCH-OIG8/20/2015 10/29/2015
HHS MDHHS-OIG
Suspended Excluded Terminated
Collier Jeffrey Home Help Sault Sainte Marie 7/8/2015 DCHCollins Travell Home Help Ypsilanti 10/31/2016 MDHHSConley Cheryl Home Help Detroit 2/3/2015 DCH
Cooper Elizabeth Home Help Lansing 4/1/2015 DCHCooper Grace Home Help Benton Harbor 11/23/2015 DCHCooper Judith Home Help Mantisique 1/30/2017 MDHHSCooper Lorena M Home Help Southfield 11/30/2015 MDHHS
Cooper Ronald J Dentist 1457443145Grosse Pointe Shores 2901009405 8/10/2017
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Corhn Brian Home Help Benton Harbor 11/30/2015 MDHHSCornelius Denice M. Physician Lansing 5101009416 5/20/2001 HHS 1128(a)(4)Corradi Martin Home Help Troy 10/29/2016 MDHHSCortez Samson Home Help Marysville 3/17/2015 DCH
Cox Wyonia Home Help Detroit 3/10/2017
MI-Licensing and Regulatory Affairs Suspended
Counts Anna Marie Home Help Ecorse 2/13/2015 DCHCrawford Keema Home Help Pontiac 3/20/2015 DCHCritchett Thomas Anthony Home Help Port Huron 2/10/2015 DCHCroft Timothy Home Help Detroit 12/12/2016 MDHHS 7/13/2017 MDHHSCroskey Kisean Lamar Home Help Pontiac 10/7/2014 DCHCross Linda K. Physician Lansing 4301041641 10/22/1991 HHS 1128(b)(4)Crothers Monica Home Help Hart 4/28/2016 MDHHSCruz Myrza Home Help Lansing 1/22/2015 DCHCummings Jessica Home Help Jacckson 12/19/2016 MDHHS
Cunningham Darrell R Physician 1902998933 Stanton 5101012407 2/6/2013
MI-Licensing and Regulatory Affairs Suspended
Cunningham Bryan Home Help Detroit 4/8/2015 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Curry Robert Home Help Detroit 4/12/2017 MDHHSCurry Teisha Laann Home Help Highland Park 11/30/2015 MDHHSCurtis Joseph Home Help[ Romulus 9/21/2017 MDHHSCutright Monterea Home Help Detroit 4/11/2017 MDHHS
Cywiak Seymour N. Physician 1780956524 Farmington Hills 5101005504 8/1/2013
MI-Licensing and Regulatory Affairs Suspended
Czertko George Physician Detroit 4301033892 HHS 1128(b)(4)
Dababneh Malik H Physician 1306853221 Dearborn 5101009532 4/10/2013
Dallman James H. Physician Muskegon 4301055294 6/17/1999 HHS 1128(a)(1)Milena Care Home Company LLC Damisch Dildora Home Help Farmington Hills 11/15/2017 MDHHS
Daniels Clarence Home Help Detroit 2/10/2016 MDHHSDaniels Reginald Home Help Pontiac 4/28/2015 DCHDaniels Tiffany Home Help Gaylord 2/13/2017 MDHHSDanis Christine Home Help Hastings 8/9/2016 MDHHS
Davidson Zyra Home Help Lansing 3/30/2017 MDHHSDavis Cassandra Home Help Kalamazoo 12/7/2017 MDHHS
Davis Horace J Physician 1033126651 Jackson 5101007157 6/29/2016 MDHHS-OIG 8/7/2017
MI- Licensing and Regulatory Affairs
Summary Suspension Summary Suspension
Davis Joey Jay Home Help Utica 12/18/2014 DCHDavis Jurmel Home Help Detroit 10/22/2015 MDHHSDavis Keshia Home Help Southfield 11/6/2017 MDHHS
Davis LindaNon Emergency Transportation Farwell 5/9/2017 MDHHS
Davis Lakeesa Home Help Detroit 5/19/2015 DCH-OIG Termination
Davis Marcella Home Help Detroit 8/11/2015 MDHHS -OIGSummary Suspension
Davis Marcus Home Help Muskegon 10/10/2017 MDHHS 4/19/2018 MDHHS
Davis Marilyn Home Help Harper Woods 11/11/2014 DCH-OIGSummary Suspension
Davis Mishondia Home Help Mount Clemens 3/14/2016 MDHHSDavis Norman Home Help Detroit 10/17/2017 MDHHSDavis Sabouriunm Home Help Lansing 1/25/2015 MDHHSDawood Rashawn Home Help Sterling Heights 3/15/2018 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Diaz Cynthia A Home Help Saginaw 12/2/2016 MDHHSDewilde Steven B. Physician Plymouth 5101009688 9/20/2005 HHS 1128(a)(4)Dick Guy Home Help Detroit 8/17/2016 MDHHSDickerson Patrick Home Help Lansing 5/1/2015 DCHDietz Brandon Home Help Alpena 11/2/2016 MDHHSDillard Michael Home Help Inkster 12/2/2015 MDHHSDixie Moses Home Help Kalamazoo 10/24/2017 MDHHS
Donaldson Joaquin Home Help Grand Rapids 4/18/2017 MDHHS
Donnellon Thomas L Physician 1073546883 Fort Gratiot 4301052611 9/23/2016
MI-Licensing and Regulatory Affairs Suspended
Dorris Lisa Home Help Baldwin 10/10/2017 MDHHSDorris Machelle Home Help Baldwin 4/22/2015 DCHDorsey Ervin Home Help Detroit 7/16/2015 DCHDorsey Orondey Home Help Detroit 11/30/2015 MDHHSDougovito Michael F. Nurse Newberry 4704107350 4/20/2000 HHS 1128(b)(4)Downer JoAnn Home Help Detroit 2/1/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Doyle Christopher Lee Home Help Pinckney 6/1/2015 DCHDrawdy Evelyn Home Help Cadillac 1/26/2015 DCHDreyfuss Donald S. Physician Bloomfield Hills 5101005825 9/20/2000 HHS 1128(a)(1)Drumm Randy E. Physician Edmore 5101009214 1/20/2003 HHS 1128(b)(4)
Duckett Bruce Devlon Dentist Flint 2901015928 3/30/2001 DCH 11/20/2002 HHS
3/30/01: Violation of Medicaid False Claim Act11/20/02: 1128(a)(1)
Dudley Kevin Home Help Detroit 2/8/2018 MDHHSDuskin Charles Home Help Detroit 2/10/2015 DCHDwight 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)
Elliott Robert L. Chiropractor Redford 2301005227 12/20/1998 HHS 1128(b)(14)Ellis Bernadette Home Help Jackson 3/23/2016 MDHHSEllis Kenya Home Help Warren 5/24/2017 MDHHS
Emerson Paul Howard Physician 1053458638 Taylor 5101010627 4/2/2009
MI-Licensing and Regulatory Affairs
Voluntary Termination
Ensley Nancy J Physician 1699715060 Duluth, MN 48610 -MN 12/8/2012 HHS & DCH SuspendedErvin Elyah Home Help Detroit 9/12/2017 MDHHSEskew Jermaine Home Help Warren 6/19/2017 MDHHSEstep Jaimie Home Help Bay City 4/7/2016 MDHHSEstes Johnny Home Help East Lansing 1/21/2017 MDHHS
Ewing Calvin Home Help Grand Rapids 11/9/2016 MDHHSEyestone Amanda Home Help Ludington 2/26/2018 MDHHSFaison Ashlie Home Help Warren 12/14/2017 MDHHSFalls Tiffany Home Help Saginaw 3/13/2018 MDHHS
Fares Adbdelkader H Physician 1083751085 Dearborn 4301043357 11/3/2014 DCH-OIG10/21/2015 10/16/2015
Fesler Jonthan home Help Dowagiac 8/17/2017 MDHHSFinch David L Home Help Jackson 11/30/2015 MDHHS
Weidman Pharmacy Fiorillo Louis J. Pharmacy Weidman 5301002898 6/22/1994 DCH 8/10/1994 HHS
6/22/94: Violation of Medicaid False Claim Act8/10/94: 1128(a)(1)
Firestone Morey H. Optometrist Dearborn 4901001455 11/19/1997 HHS 1128(a)(2)Fish Jason Home Help Pontiac 8/17/2017 MDHHSFisher Alvin Home Help Detroit 8/3/2017 MDHHS
Flack Ronald JNurse Practitionerr 1477606614 Jackson, MI 4704149271 5/15/2015 HHS Excluded
Fletcher Robert Home Help Crystal 8/11/2015 MDHHSFloyd-Martin Gerald Home Help Grand Rapids 7/24/2017 MDHHS
Flusty Richard Chiropractor 1275675415 Warren 2301004626 8/28/2012
MI-Licensing and Regulatory Affairs Suspended
Ford Allen Home Help Benton Harbor 12/22/2014 DCH
Fort Newland C. Podiatrist Detroit 5901000496 3/18/1987 DCH 4/21/1988 HHS
3/18/87: Violation of Medicaid False Claim Act4/21/88: 1128(a)(1)
Forte Sandra L. Chiropractor Detroit 2301005177 1/6/1997 HHS 1128(b)(14)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Fortner Sean D Home Help Flint 5/19/2015 DCHFortune Aaron Home Help Detroit 12/16/2015 MDHHSFossett Tyrone Home Help Detroit 3/28/2016 MDHHSFoster Charles Home Help Benton Hrabor 8/22/2016 MDHHSFoster Larry Earl Home Help Detroit 5/15/2015 DCH
Fowler Carl D Physician 1417989476 Detroit 4301045243 7/3/2013 DCH-OIG
4/15/2014 01/23/2015 03/19/2015 04/10/2015
DCH-OIG MI-Licensing and Regulatory Affairs HHS MI-Licensing and Regualtory Affairs
Freedland Joel E. Physician Lincoln Park 5101007189 8/7/1987 HHS 1128(a)(1)Freeman Richard F. Physician Detroit 4301026316 5/20/1998 HHS 1128(b)(4)Freeman Sean Home Help Detroit 2/22/2018 MDHHSFreeney Antoine Home Help Southgate 3/28/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Freidl Harold D Physician 1962470435 Kalamazooo 4301036711 1/15/2013
MI-Licensing and Regulatory Affairs Suspended
Friedman Kenneth M. Dentist Roseville 2901014795 10/20/2003 HHS 1128(a)(2)Frierson Andre Home Help Muskegon 6/8/2017 MDHHSFrye 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 DCHFuller Damon Home Help Detroit 9/21/2016 MDHHS
Funderburg Clinical & Community Services Inc. Funderburg, Jr. Gerald R. Physician Group 1225254279 Detroit 5/29/2012 DCH
Summary Suspension
Fyn Mark Stephen Physician 1669624201 Roseville 4704201153 9/15/2009
MI-Licensing and Regulatory Affairs Suspended
Gaft Richard SNurse Practitioner 1578626735 Gladwin 4704201154 8/13/2016
MI-Licensing and Regulatory Affairs Suspended
Gainous Anthony Home Help Detroit 11/14/2017 MDHHSGalbriath Donnie Home Help Alpena 11/30/2015 MDHHSGalmore Terry Home Help Lansing 12/31/2016 MDHHS
Gandy Kyle D Physician Assistan1154502623 Midland 5601005166 4/15/2016
MI-Licensing and Regulatory Affairs 7/20/2016 HHS-OIG
Summary Suspension Excluded
Garcia Curtis Home Help Chesterfield 7/7/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Gardner Sara Home Help Warren 11/30/2015 MDHHSGarner James Home Help Warren 4/7/2016 MDJHHSGarrison Earl Home Help Detroit 12/6/2017 MDHHSGarvie Joline HomeHelp Charlotte 11/30/2017 MDHHS
Garvin Emily S. Registered Nurse Adian 4704245386 10/1/2013 HHS 1128(a)(4)American Orthopedic Service, Inc. Gaskins Lawrence L.
Orthotist/Prosthetist Bay City 11/25/1991 HHS 1128(a)(1)
Gebhardt Mark James Home Help Houghtan Lake 3/31/2015 DCHGeha, James G. DPM, PC Geha James G. Podiatry Group Madison Heights 5901001042 3/18/1999 HHS 1128(a)(1)
George Laheeb Home Help Sterling Heights 8/31/2016 MDHHSGeorge Lisa Home Help Pontiac 2/18/2016 MDHHS
Geralt John A Physician 1972839447 Roseville 4301021869 7/30/2013 DCH-OIG
8/18/2016 01/31/2017 08/07/2017
HHS-OIG MI-Licensing and Regulatory Affairs MI- Licensing and Regulatory Affairs
Suspended Excluded Summary Suspension Revoked
Geter Nancy Home Help Detroit 11/30/2015 MDHHSGibbs Ebony Home Help Grand Rapids 10/17/2016 MDHHSGiles Jeff Home Help Detroit 11/30/2015 MDHHSGill William T Home Help Highland Park 11/30/2015 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Gillihan Todd M Physician 1255474045 Chelsea 4901004251 10/20/2014
MI-Licensing and Regulatory Affairs 2/24/2016
MI-Licensing and Regulatory Affairs
Summary Suspension Summary Suspension
Gipson Dion Home Help Detroit 2/8/2018 MDHHSGipson James E Home Help Saginaw 12/3/2014 DCHGlover Jamal Home Help Flint 10/18/2016 MDHHSGlover Michelle Home Help Grand Rapids 7/7/2016 MDHHS
Godiali Vasso Godziashvili Physician 1861572000 Bay City 4301065556 9/30/2015 MDHHSSummary Suspension
Godoy Carlos Physician 1881654705 Livonia 4301033015 3/31/2016 MDHHS-OIGSummary Suspension
Goins Rondy D Podiatrist 1508904798 Detroit 5901001535 6/7/2012 DCH Suspended Golden Takah Home Help Muskegon 8/23/2016 MDHHS
Goldfein Aaron S Physician 1053354787 Dearborn 4301082782 5/6/2014 DCH-OIG2/14/2016 05/17/2017
MI-Licensing and Regulartory Affairs MI- Licensing amd Regulatory Affairs
Summary Suspension and Termination Suspension Suspended
Gomez Alexander R Home Help Pinconning 4/9/2015 DCHGonzales Edward Home Help Detroit 4/19/2018 MDHHSGonzalez-Tapia SanJuanita Home Help Lansing 4/24/2015 DCHGooden Laurence Home Help Detroit 12/12/2017 MDHHSGoodman Jaimar Home Help Detroit 9/6/2016 MDHHS
Gordon Carolyn Home Help Flint 6/4/2015 DCH-OIGSummary Supension
Gordon Ken Home Help Lansing 12/17/2015 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Gorosh Richard P. Podiatrist Lansing 5901001179 2/20/2001 HHS 1128(a)(1)
Gotcher Latrise Home Help Detroit 7/13/2016 MDHHS-OIG 4/20/2017 HHS
Summary Suspension Excluded
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)Gramse Lawrence Home Help Flint 2/26/2015 DCHGrant Kelvin Renald Home Help Detroit 1/14/2015 DCHGrant Tammy Home Help White Cloud 8/23/2017 MDHHSGrappin Brian L. Chiropractor 1003931999 Flushing 2301002891 9/19/2002 HHS 1128(a)(3)Gray William Home Help Detroit 1/14/2015 DCH
Gray Yev Podiatrist 1821006396 Chicago 5901002069 9/21/2017
MI- Licensing and Regulatory Affairs Suspended
Green Anthony Home Help Ludington 5/3/2016 MDHHSGreen Kejuan Home Help Detroit 7/12/2016 MDHHSGreen Kevin Home Help Southfield 3/6/2018 MDHHSGreen Rosezetta Home Help Detroit 9/18/2015 MDHHS
Greenbain Mark Psychiatrist 1326093709 Clinton 4301030022 9/26/2011 DCHSummary Suspension
Greenberg William A. Optometrist Harper Woods 4901002254 10/19/2006 HHS 1128(a)(2)Greene Antonio Home Help Kalamazoo 7/10/2015 DCHGreene Marcell Home Help Detroit 12/7/2017 MDHHSGress Raymond C. Chiropractor Lake City 2301004963 4/10/1997 HHS 1128(b)(14)
Griffin Erma Home Help Battle Creek 10/9/2014 DCHGriffin Lonnie Leandry Home Help Pontiac 10/20/2014 DCHGriffin Kendricks Home Help Pontiac 2/14/2017 MDHHSGriffin Willedtra Home Help Detroit 5/3/2016 MDHHSGriffith Curtis Evan Home Help Detroit 11/30/2015 MDHHSGrimmitt Joseph C Home Help Westland 11/21/2014 DCHGrissom Stanley Willis Home Help Muskegon 11/19/2014 DCHGross Charles Home Help Edwardsburg 3/7/2016 MDHHSGross Robert Home Help Midland 11/3/2015 MDHHSGrubaugh Lisa Marie Home Help Harrison 6/12/2015 DCHGuerra Robert Home Help Flint 10/20/2014 DCHGuest Noelle Home Help Merritt 7/21/2016 MDHHS
Be Well Pharmacy Gujarathi Chetan Pharmacy 1891028759 BerkleyNCPDP 2373227 8/19/2011 DCH 5/30/2016 MDHHS- OIG
Summary Suspension Termination
Gunner Concetta Home Help Detroit 11/30/2015 MDHHSGutz Donald Home Help Wyandotte 4/28/2016 MDHHSGuyton Jimmie Home Help Detroit 12/17/2015 MDHHSHaacke Tracy Home Help Alpena 5/10/2016 MDHHS
Airport Apothecary Haber Maria Pharmacy 1831422294 Waterford
NCPDP 2373253 8/23/2011 DCH 6/2/2016 MDHHS-OIG
Summary Suspension Terminated
Rx Now Pharmacy Haber Maria Pharmacy 1619297553 LivoniaNCPDP 2374116 8/19/2011 DCH 6/2/2016 MDHHS-OIG
Summary Suspension Terminated
Tri-City Apothecary Haber Maria Pharmacy 1144554106 Saginaw
NCPDP 2373265 8/19/2011 DCH 5/23/2016 MDHHS-OIG
Summary Suspension Termination
Hakim Marvin Home Help Oak Park 6/13/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Haq Abdul Physician 1033227434 Ypsilanti 4301033697 7/12/2017
MI-Licensing and Regulatory Affairs
Disciplinary Limited License
Hardman Donald J Physician 1013906700 Flint 4301062726 11/28/2015
MI-Licensing and Regulatory Affairs Suspended
Hardrick Tanya Home Help Detroit 10/19/2016 MDHHSHarvey Kelvin Home Help Detroit 9/26/2017 MDHHSHardville Travis C Home Help Detroit 6/2/2015 DCHHardy Andrew Physician 1710101688 Traverse City 4301046774 11/20/2002 HHS 1128(a)(1)
Harper George Home Help Eastpointe 7/22/2015 MDHHS-OIG
Summary Suspension and Termination
Harper Samuel Home Help Manistee 3/7/2016 MDHHSHarrell Ebony Home Help Detroit 5/11/2017 MDHHSHarrell Pamela Home Help Warren 11/10/2014 DCHHarrell William Home Help Detroit 4/19/2016 MDHHSHarrien Braandon Home Help Muskegon 1/4/2016 MDHHSHarris Cedrick Home Help Three Rivers 3/20/2015 DCHHarris Frank W. Dentist 1578615209 Detroit 2901008049 5/26/1997 HHS 1128(b)(4)Harris Martinez Home Help Warren 11/30/2015 MDHHSHarris Tracey Home Help Detroit 4/4/2016 MDHHSHarris-Ivey Marion Home Help Flint 4/7/2015 DCHHarsten Kidadah Home Help Detroit 10/29/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Hartsuff Jenni Physician 1972544518 East Lansing 4704178226 10/28/2008
MI-Licensing and Regulatory Affairs
Summary Suspension
Harvey Tamika Home Help Detroit 12/17/2015 MDHHSHasan Nafeesa Home Help Pontiac 9/19/2017 MDHHSHasberry Michael Home Help Southfield 12/17/2014 DCHHatten Towanda Home Help Grand Rapids 11/7/2016 MDHHSHaekins Brittany Home Help Hollnad 02/220/2018 MDHHSHawkins Mary Home Help Owosso 9/15/2015 MDHHSHayes Antwaune Home Help Saginaw 12/10/2014 DCHHayes Norman Home Help Port Huron 1/18/2018 MDHHSHayes William Home Help Detroit 3/7/2016 MDHHSHeath Beverly Home Help Detroit 6/21/2016 MDHHSHearns Ben J. Dentist Detroit 2901014305 2/5/1997 HHS 1128(b)(14)Hedgecorth Julia Anne Physician Albion 4301045086 4/2/2001 HHS 1128(b)(4)Heeren Nancy Home Help Grand Rapids 7/25/2017 MDHHSHeidenga Scott HomeHlep Holland 2/12/2018 MDHHS
Heiney Jake P Physician 1215081773 Lambertville 35090990 9/15/2015 MDHHS-OIG6/28/2016 02/10/2017
MI-Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs
Summary Suspension Summary Suapension Revoked
Heinze Adam Home Help Cheboygan 11/28/2016 MDHHSHemphill Robert A. Physician 1073608774 Saginaw 5101006231 8/20/2002 HHS 1128(a)(3)Henderson Ericka Home Help Mount Morris 4/7/2016 MDHHSHenderson Phillip John Home Help Detroit 4/21/2015 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Henderson Richard M. Dentist North Pontiac 2901006073 2/4/1992 HHS 1128(a)(1)Henderson Sean Home Help Clint Twp 12/1/2014 DCHHenderson Malik Home Help Detroit 12/4/2015 MDHHS
Hennessy Michael E Dentist 1396820460 Farmington Hills 2901014529 12/12/2011
MI-Licensing and Regulatory Affairs Suspended
Hernandez Laureane Home Help Pontiac 2/6/2015 DCHHernandez Jose Home Help Clinton township 4/19/2016 MDHHS
Herold Arthur D Physician 1982602686 West Bloomfield 5101005640 3/30/2017
MI-Licensing and Regulatory Affairs 7/19/2017 HHS-OIG
Summary Suspension Excluded
Herrero Adelina W Physician 1740340264 Ypsilanti 4301032776 4/15/2014 DCH-OIG
11/22/2014 12/18/20144/10/2015
MI-Licensing and Regulatory Affairs HHS MI-Licensing and Regulatory Affairs
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)Higgs Rose Home Help Otsego 7/26/2017 MDHHSHill Bradley Home Help River Rouge 11/19/2016 MDHHSHill Jerry Home Help Saginaw 12/2/2016 MDHHSHill Qunatrell Home Help Inkster 8/29/2016 MDHHS
Hines Derrick Home Help Detroit 6/8/2015 DCH-OIG
Suspended and Terminated
Hinman Pharmacy (dba Medical Arts Pharmacy) Hinman William Pharmacy Grand Blanc 5301004202 1/3/1989 HHS 1128(a)(1)
Hoch Jeffrey C. CRNA 1215040589 Jackson 4704146933 3/2/2015
MI-Licensing and Regulatory Affairs
Summary Suspension
Hoda Syed Tanweerul Physician Trenton 4301060045 10/20/2005 HHS 1128(b)(4)Hodge Andrea Home Help Detroit 11/7/2017 MDHHSHodges Carla Home Help Grand Rapids 4/18/2018 MDHHS
Hoeltzel Mark F Physician 1801910617 Ann Arbor 4301083829 12/21/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Holda Michael Physician 1427029925 Howell 4301036662 10/22/2013 DCH3/26/2013 07/20/2015
MI-Licensing and Regulatiory Affairs
Summary Suspension Suspended
Holet James Home Help Westland 5/8/2015 DCHHoliday Jermaine R Home Help Grand Rapids 11/30/2015 MDHHSHollida Sharieffe L Home Help Highland PArk 1/28/2017 MDHHSHolloway Lawrence M. Physician Flint 5101008603 11/19/1997 HHS 1128(b)(4)Holloway Nathaniel Dentist Ypsilanti 2901006451 8/7/1997 HHS 1128(a)(1)Holmes Jerrain Home Help Detroit 10/8/2015 MDHHS
Hooper Mary K Registered Nurse 1700076684 Ishpeming 4704244897 11/21/2012
MI-Licensing and Regulatory Affairs Suspended
Hopkins Danial Physician Mount Pleasant 4301405717 5/20/2001 HHS 1128(a)(1)Hopkins Kenneth R Home Help Pinckney 3/27/2015 DCHHoward Danny Home Help Rives Junction 9/29/2016 MDHHSHoward Demetrius D Home Help Detroit 5/22/2015 DCHHoward Earl Home Help Detroit 11/15/2017 MDHHSHoward Fred Jerome Home Help Gobles 3/25/2015 DCHHoward Lillardo Home Help Flushing 12/12/2016 MDHHSHoward Terrence Home Help Detroit 12/16/2015 MDHHSHoward Timothy Devon Home Help Lansing 3/6/2015 DCH
Howe Clarence G. Physician Detroit 5101003031 3/18/1987 DCH
Violation of Medicaid False Claim Act
Howell Monica Home Help Bay City 9/7/2017 MDHHSHuddleston Shannon Home Help Benton Harbor 5/31/2017 MDHHSHuddleston Sheila Diane Home Help Detroit 10/22/2014 DCHHudson Donald L. Chiropractor 1255488615 East Lansing 2301005765 2/2/2006 HHS 1128(b)(14)Huestis Christina Home Help Bay City 10/20/2014 DCHHughes Timothy Home Help Belleville 11/30/2015 MDHHSHughey Danny Home Help Muskegon 5/1/2014 DCHHugle Alden Home Help Detroit 10/17/2016 MDHHSHulbert Melissa Home Help Jackson 12/27/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Hussain Murtaza Physician- 1043238421 Detroit 4301057047 4/6/2015 DCH--OIG
8/11/2015 05/19/2016 06/02/2016
MI-Licensing and Regulatory Affairs HHS-OIG MDHHS-OIG
Summary Suspension Summary Suspension Excluded
Huynh Thanh Home Help Grand Rapids 7/12/2016 MDHHSHydrick 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 DCHIngram Kimberly Home Help Detroit 7/20/2016 MDHHSIsaac Connie Home Help Port Huron 1/25/2018 MDHHSIverson Tracey Lorene Home Help Port Huron 1/12/2015 DCH
Ivory Jackie Home Help Bruceton Mills, WV 6/30/2016 MDHHS-OIG
Iyer Ravi Physician 1467493791 Detroit 4301082017 7/30/2013 DCH-OIG 3/20/2017
MI- Licensing and Regulatory Affairs
Suspended Summary Suspension
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Jackson Cassandra P Home Help Detroit 12/11/2014 DCHJackson Darryl HomeHelp Detroit 11/9/2017 MDHHSJackson James Home Help Grand Rapids 2/19/2015 DCHJackson Lakeya Home Help Saginaw 9/29/2017 MDHHSJackson Latoya Nicole Home Help Detroit 4/13/2015 DCHJackson Mark Home Help Detroit 2/27/2017 MDHHSJackson Timeko Home Help Flint 1/30/2017 MDHHSJackson Wanda Home Help Detroit 7/31/2015 MDHHSJacobs Jerome Home Help Detroit 12/28/2016 MDHHSJacobson Suzanne Home Hep Interlochen 10/20/2017 MDHHSJakubiak Paul J. Physician Lansing 4301027820 3/20/2003 HHS 1128(b)(4)Jamar Marnez Home Help Eastpointe 11/30/2015 MDHHSJames David Home Help Saginaw 8/17/2017 MDHHSJames Marilyn Home Help Lansing 1/26/2017 MDHHSJames Yakeena K Home Help Detroit 11/30/2015 MDHHS
Jennings Gregory Home Help Detroit 1/15/2015 DCHJennings Sophia Loen Home Help Dearborn Heights 11/13/2014 DCH
Jerkins Waymon D.Podiatrist/Medical Supplier Detroit 5901000834 7/6/1993 DCH 7/29/1997 HHS
7/6/93: Violation of Medicaid False Claim Act7/29/97: 1128(a)(1)
Johnson Angelo Home Help Detroit 6/10/2015 DCHJohnson Bunny Home Help Kalamazoo 2/10/2018 MDHHSJohnson Charles Home Help Pontiac 10/29/2016 MDHHSJohnson Charles Home Help Muskegon 12/9/2015 MDHHS
Johnson Christa M. Chiropractor 1629292909 Manistee 2301007649 12/16/2017
MI-Licensing and Regulatory Affairs Suspended
Johnson Eric Home Help Kalamazoo 12/17/2014 DCHJohnson Falando Home Help Detroit 10/4/2016 MDHHSJohnson Flossie Home Help Detrout 10/3/2017 MDHHSJohnson Jimmy Edward Home Help Roseville 10/20/2014 DCHJohnson Keithley E. Physician Dearborn 4301032641 8/14/1995 HHS 1128(b)(3)Johnson Kisha Home Help Detroit 4/30/2015 DCHJohnson Larry Otis Home Help Detroit 10/23/2014 DCHJohnson Maria Home Help Detroit 8/3/2017 MDHHSJohnson Robert Home Help Ecorse 4/12/2018 MDHHSJohnson Stephen Home Help Lansing 1/25/2016 MDHHSJohnson Tiaka Home Help Grand Rapids 8/14/2017 MDHHSJohnson Tracy Home Help Kalamazoo 12/23/2014 DCHJohnson Julius A Home Help Detroit 11/30/2015 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Jones Dmarcus Home Help Roseville 3/16/2015 DCHJones Derrick Earl Home Help Wayne 11/30/2015 MDHHSJones Ivan Home Help Wayne 7/6/2017 MDHHSJones Jacquetta Home Help Benton Harbor 8/23/2017 MDHHSJones Helen Home Help Detroit 12/18/2014 DCHJones Jemien Zardo Home Help Flint 4/3/2015 DCHJones Julias Home Help Milan 11/24/2014 DCHJones Lacarol Tealette Home Help Detroit 1/23/2015 DCH
Jones Mark Psychologist 1558474585 Port Huron 6301011246 9/5/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Jones Marquett Home Help Detroit 11/30/2015 MDHHSJones Monique Home Help Grand Rapids 9/14/2016 MDHHSJones Turquoise Sabrina Home Help Grand Rapids 2/19/2015 DCHJones- Wert Darlene Home Help Hillsdale 10/6/2016 MDHHSJordan Brandon Home Help Detroit 9/27/2016 MDHHS
Joseph Edward Physician 1598719809 Mount Clemens 5101012963 4/4/2008
MI-Licensing and Regulatory Affairs
Summary Suspension
Judkins Kelvin Home Help Grosse Pointe 9/1/2016 MDHHS
Jurek-D'Andrea Kristina Home Help Macomb 2/19/2014 DCH-OIG 8/26/2015 DCH-OIG
Summary Suspension Terminated
Kafi Alex A Physician 1578586772 West Bloomfield 4301043089 12/14/2017
MI-Licensing and Regulatory Affairs Suspended
Kalinski Shawn Home Help Detroit 6/5/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Kamp Marc R Dentist 1952427254 Bloomfield Hills 2901015510 1/9/2016
MI-Licensing and Regulatory Affairs
Summary Suspension
Karas KennethNon Emergency Transportation Lake 5/31/2017 MDHHS
Kates Jeremiah Home Help Lansing 1/20/2016 MDHHSKaufman, Jack A. DPM, PC (aka Novi Footcare Associates PC) Kaufman Jack A. Podiatry Group Novi 5901000903 9/19/2003 HHS 2/20/2006 HHS
Kazma Robert M. Chiropractor Detroit 2301002964 9/20/2001 HHS 1128(a)(1)Keels Ramone Home Help Saginaw 11/30/2015 MDHHS
Keen Marc E Physician 1851362966 Ludington 4301057451 1/17/2018
MI-Licensing and Regulatory Affairs
Disciplinary Limited License
Keen-Centofanti Judith R. Chiropractor Imlay City 2301006875 3/6/1997 HHS 1128(b)(14)Kelley Cheryl Ann Home Help Muskegon 12/3/2014 DCHKelley Demetric Home Help Detroit 4/28/2016 MDHHSKellum Marlon R Home Help Detroit 11/30/2015 MDHHS
Kelly Paul A Physician 1932351715 Southfield 4301051333 7/30/2013 DCH-OIG 9/30/2013 HHSTerminated1128(a)(1)
Kelly, Jr. James J. Physician 1316975386 Troy 4201054938 4/27/2008
MI-Licensing and Regulatory Affairs
Summary Suspension
Kemp Michael Physician Group Detroit 8/29/1990 HHS 1128(a)(1)All Care Medical Center Inc. Kennedy Donald R. Physician Flint 5101003922 4/12/1993 HHS 1128(a)(1)
Kennedy David Roderick Home Help Detroit 11/30/2015 MDHHSKennedy Dominque Home Help Oak Park 4/7/2016 MDHHSKenue Lakshmi Physician Detroit 4301050782 3/29/1990 HHS Suspended
Kern Steven A. Chiropractor 1528199403 Marine City 2301005582 8/25/2013
MI-Licensing and Regulatory Affairs
Summary Suspension
Kerr Ellen Nurse 1588783484 Bloomfield 4704096047 1/5/2011 DCHVoluntarily surrendered
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Ketcham Donn W. Physician 1598742702 Allendale 4301023446 2/24/2012
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Khan, Walayata MD, PC Khan Walayata A. Physician 1497779649 Ypsilanti 4301042910
2/11/1996 05/06/2014
HHS DCH-OIG 3/30/2015 DCH-OIG
1128(a)(1) Summary Suspension Termination
Khanbai Javeed Home Help Lansing 3/23/2017 MDHHS
Khurana Suresh P. Physician 1790859205 Harrison Township 4301031380 3/18/2011
MI-Licensing and Regulatory Affairs Drug diversion
Kiefer Kathryn M CRNA 1629148119 Grosse Pointe 4704170474 6/9/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Kilpatrick Kerry Physician- 1568517225 Grand Rapids 2301004267 10/27/2011
MI-Licensing and Regulatory Affairs Suspended
Kim Dong Irl Physician Holland 4301039383 6/20/2000 HHS 1128(b)(4)Kincaid Shamika Latrice Home Help Southfield 2/17/2015 DCHKingen Kevin Home Help Redford 8/18/2015 MDHHS
J & J Sleep, Inc. Kingen Jack Physician Group Durand 4/8/2004 DCH
Violation of Medicaid False Claim Act
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
American Medical Supply, Inc. Kinsella Michael O. Medical Supplier Detroit 7/29/1996 DCH
Violation of Medicaid False Claim Act
Kirkland George Home Help Wyoming 1/16/2018 MDHHSKirkland Steven Home Help Detroit 4/12/2017 MDHHSKizer Theoloneus Home Help benton Harbor 10/24/2017 MDHHS
Kizzy Wafid W. Dentist 1366564122 Oak Park 2901017596 1/18/2017 MDHHS-OIGSummary Suspension
Klein Alan Chiropractor Detroit 2301004270 3/18/1987 DCH 12/16/1986 HHS
3/18/87: Violation of Medicaid False Claim Act12/16/86: 1128(a)(1)
Kleinert Kathleen M Physician 1336156231 Detroit 5101013318 11/24/2012
MI-Licensing and Regulatory Affairs
Knight Keith Home Help Pontiac 3/22/2017 MDHHSKnox Charles Ramon Home Help Detroit 11/30/2015 MDHHSKoffeman 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
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Lauchu Carlos M. Physician Saline 4301029754 3/16/1995 HHS 1128(b)(4)Lauderdale Selena Home Help Grand Rapids 5/27/2015 DCHLawrence Brian Home Help Warren 2/16/2017 MDHHS
East Side Pharmacy, Inc. Lazar Calvin R. Pharmacy Flint 12/17/1997 HHS 1/4/1984
12/17/97: 1128(b)(1)1/4/84: 1128(a)(1)
Leamon Yolanda G. Physician Battle Creek 4704106771 7/20/2000 HHS 1128(b)(4)
LeBaron Troy J Optometrist 1124210091 Ada 4901114426 7/3/2017
MI-Licensing and Regulatory Affairs 3/5/2018
MI-Licensing and Regulatory Affairs
Summary Suspension dissolved Suspended
Lee Edith J. Physician Highland Park 4301022981 8/14/1986 HHS 1128(a)(1)Lee John Home Help Wyoming 11/29/2016 MDHHS
Lee Sang H. Physician 1679790836 Detroit 4301032091 9/21/2011 DCHSummary Suspension
Cascade Pharmacy Leen Charles J.
Pharmacy/Medical 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)
Leeshaun Buie Home Help Detroit 11/30/2015 MDHHS
Leete James Physician 1467476937 Traverse City 4301041116 8/16/2014
MI-Licensing and Regulatory Affairs Suspended
Leftwich Carl L. Dentist Detroit 2901007003 8/1/1990 HHS 1128(b)(4)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Lesley Jusy Home Help Kalamazoo 3/29/2016 MDHHSLewis Andrew L Home Help Detroit 3/4/2015 DCHLewis Dorothy Home Help Detroit 12/12/2016 MDHHS 1/10/2018 MDHHSLewis Kevin Home Help Detroit 9/29/2015 MDHHSLewis Maurice Home Help Lansing 11/30/2015 MDHHSLewis Pharen Home Help Detroit 9/6/2016 MDHHSLewis Terrance Home Help Highland Park 11/3/2014 DCHLieberman 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)Lilleberg Jessica Home Help Cadillac 7/7/2015 DCHLilly Latoya Home Help Holt 11/30/2015 MDHHSLim Billy Shee Dentist 1942356183 Detroit 2901015899 12/1/2007 HHS 1128(a)(1)
Linares Oscar A Physician 1689641458 Dearborn 4301045607 3/21/2013 DCH
09/20/2016 02/10/2017 04/20/2017
MI-Licensing and Regulatory Affairs MI- Bureau of Licensing and Regulatory Affairs HHS
Suspended Summary Suspension Revoked Excluded
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Lindsey Tommy G. Chiropractor Mount Morris 2301002099 5/20/1998 HHS 1128(b)(4) Little Daniel Home Flint 2/9/2017 MDHHS
Lloyd Christopher Detroit 9/13/2016 MDHHSRitecare LLC Lobato Hans Group 1609035104 Livonia 1/19/2012 HHS 1128(b)fRitecare LLC Lobato Hans Group 1508064775 Livonia 1/19/2012 HHS 1128(b)fMobility Matters 360 INC Lofton Don
Non Emergency Transportation Adrian 1/2/2018 MDHHS
Londree Kim Home Help Iron Mountain 4/16/2018 MDHHSLong Lisa Home Help Kalamazoo 1/31/2018 MDHHSLong Tashema Home Help Detroit 11/30/2015 MDHHSLonsby Bonnie Home Help Port Huron 4/28/2016 MDHHSLooney Samuel Home Help Detroit 3/7/2017 MDHHS
Loop William C. Physician 1710926944 East Tawas 4301042646 9/2/2009
Lowe Raphael Home Help Inkster 2/22/2018 MDHHSLowery Danny Home Help Detroit 9/11/2017 MDHHSLucas William A. Physician Dearborn 4704127471 4/20/2000 HHS 1128(b)(4)Lucero Michelle Home Help Battle Creek MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
MacLean Charles A. Physician Owosso 4301025670 8/29/1995 HHS 1128(b)(4)Madden Frances S Physician 1801850292 Grand Rapids 4301077568 7/20/2015 HHS ExcludedMadden Torrnece Hiome Help Grand Rapids 11/12/2016 MDHHSMaddox Juanita Jean Home Help Detroit 3/16/2015 DCHMagee Elizabeth Home Help Carsonville 1/20/2016 MDHHS
Mahabeer Howard Leslie Physician 1861449696 Reed City 4301048268 8/10/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Makki Ali S. Physician 1114032414 Dearborn 4301048780 9/20/2011 HHS 1128(a)(1)Motor City Nutritional Support Makowski Dennis Medical Supplier Hamtramck 6/4/1995 HHS 1128(a)(1)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Malhotra Rajesh Physician 1891748547 Detroit 4301097855 9/8/2015
MI-Licensing and Regulatory Affairs 6/30/2016
MI-Licensing and Regulatory Affairs
Summary Suspension Summary 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 Kevin Louis Home Help Grand Rapids 12/1/2014 DCH 4/19/2018 MDHHSMammo Waleed Dentist 1598939811 Sterling Heights 2901015678 4/10/2007 DCH TerminatedMann Dejohn Home Help Grand Rapids 5/13/2015 DCH
Manor James P.Nurse Anesthetist 1508912692 Wyandotte 4704136317 4/1/2014
MI-Licensing and Regulatory Affairs Suspended
Mape Avelino Marbella Physician Detroit 4301036423 9/23/1983 HHS 1128(a)(1)
Marang Boitshoko P. Physician Detroit 4301407569 2/15/1995 HHS 4/10/1996 HHS
2/15/95: 1128(b)(4)4/10/96: 1128(a)(1)
Marcano Carlos A. Physician 1639125040 Grand Rapids 4301057357 11/24/2008
MI-Licensing and Regulatory Affairs
Summary Suspension
Metric Medical Lab Marcus Carl Laboratory Southfield 3/1/1992 HHS 1128(a)(1)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Markowski Stephen Home Help Atlanta 10/13/2016 MDHHSMarnach Richard L Physician 1619923034 Minneapolis -MN 30333-MN 1/2/2013 HHS & DCH SuspendedMarshall Tanea Home Help Grand Rapids 11/17/2017 MDHHSMartin Daniel Home Help Detroit 4/21/2016 MDHHSMartin Dennis Home Help Detroit 12/14/2017 MDHHS
Life Line Transportation Martin Lenora
Non Emergency Transportation Detroit 6/8/2017 MDHHS 1/2/2018 MDHHS
Martin Michael Home Help Detroit 8/22/2017 MDHHSMartin Roert HomeHelp Detroit 2/13/2018 MDHHSMartin Terrell Home Help Detroit 6/5/2017 MDHHSMartinez Joseph Home Help Ecorse 1/13/2016 MDHHSMartinez Martin M Home Help 10/1/2015 MDHHS
Mason Marian Y Dentist 1295967438 Detroit 2901011681 8/1/2014
MI-Licensing and Regulatory Affairs Suspended
Mason Stephen B Physician 1528390259 Morgantown, WV 4301097993 2/20/2018 MDHHS Excluded
Masserant John C. Physician 1669454146 Monroe 4301076801 11/12/2015 MDHHS
4/5/2016 08/24/2016 08/20/2017 09/20/2017
MI-Licensing and Regulatory Affiars MI- Licensing and Regulatory Affairs HHS MDHHS-OIG
Mays Thomas D Physician 1255344339 Southfield 4301043030 9/16/2017
MI-Licensing and Regulatory Affairs
Disciplinary Limited License
Parkside Mental Health, Inc. Mayberry Marie Victoria Physician Group Detroit 11/19/1998 HHS 1128(a)(1)
Mayfield Stephanie Marie Physician 1740238286 Flint 4704167920 1/14/2009
MI-Licensing and Regulatory Affairs
9/21/2015 01/09/2016
MI-Licensing and Regulartory Affairs Mi- Licensing amd Regulatory Affairs
Suspended Suspended
Maynard Jamie Home Help Midland 6/21/2016 MDHHSMays Sandra D Home Help Detroit 11/30/2015 MDHHSMazer Joel Allen Optometrist Flint 4901003693 9/20/2004 HHS 1128(a)(2)Mcabee Davies E Home Help Lansing 4/14/2015 DCH
Premier Non-Medical McBride Joshua
Non Emergency Transportation Wyoming 1/16/2018 MDHHS
McBride Stellana M Home Help Lansing 3/25/2015 DCHMcCall Darnell Home Help Detroit 5/13/2016 MDHHSMcCane Ariel Home Help Detroit 3/23/2017 MDHHSMcCartney James R. Physician Bay City 4301041608 7/30/1986 HHS 1128(a)(1)McCarver Williemendia Home Help Detroit 2/10/2016 MDHHSMc Caskell Ruthie Home Help Detroit 3/10/2016 MDHHSMcCaster Kenneth Home Help Hazel Park 11/30/2015 MDHHSMcClain Raymond Home Help Mendon 10/4/2017 MDDHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Behavioral Dynamics PC McCloud Thomas SA Treatment Detroit 7/29/1985 HHS 1128(a)(1)
McCovery Sherman Home Help Flint 4/7/2016 MDHHSMcCoy Cedric Home Help Detroit 10/16/2015 MDHHSMcCray Marcus Home Help Saginaw 3/9/2017 MDHHSMcCullen Scinicor Home Help Saginaw 11/19/2015 MDHHSMcCullum John Home Help Caro 4/11/2017 MDHHS
McCutchen III William Physician 1477507739 Wagram, NC 5101014673 9/11/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
McDonald Catrina Home Help Pontiac 12/7/2015 MDHHS McEwen Timothy Home Help Detroit 7/13/2017 MDHHS
McFarland Nicholas Home Help Detroit 1/11/2018 MDHHSMcFee Kiemar HomeHelp Detroit 11/21/2017 MDHHSMcKinney Carolyn Home Help Muskegon 6/13/2016 MDHHSMcKinney 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 DCHMcMullen Scinicor Home Help Detroit 11/19/2015 MDHHSMcPhail William L. Physician Detroit 4301030183 7/30/1990 HHS 1128(a)(1)Meeks Ricky Home Help Muskegon 2/18/2015 DCH
Access Care Home Care, Inc Mehood Zafar
Home Health Agency 1134174006 Ypsilanti 5/22/2012 DCH
Summary Suspension
Melchor Arthu Allen Home Help Adrian 2/24/2015 DCHMelton Bradley Home Help Detroit 11/16/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Melton Mark R.Physical Therapist 1861504425 Gaylord 5501009879 12/28/2007
MI-Licensing and Regulatory Affairs
Summary Suspension
Mendoza Samuel Physician Dearborn 4301020703 5/6/1997 HHS 1128(b)(4)Merkle Clifton Home Help White Pigeon 4/7/2016 MDHHSMerritt Edward Home Help Detroit 3/13/2018 MDHHSMerritt Michael Home Help Detroit 11/30/2015 MDHHS
Michkovits, John F. PC Michkovits John F. Dental Group South Haven 2901008784 3/19/1999 DCH 6/17/1999 HHS
3/19/99: Violation of Medicaid False Claim Act6/17/99: 1128(a)(1)
Mickel John HomeHelp Grand Rapids 11/21/2017 MDHHSMickel Kenyatta Home Help Detroit 9/13/2016 MDHHSMiddleton 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)
Mihailoff nevena M Physician 1740280569 dearborn 4301039159 1/17/2018
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Miky Mansour A Physician 1023080512 Marquette 4301082652 9/23/2016
MI-Licensing and Regulatory Affairs Suspended
Miles Zekenia Home Help Grand Rapids 1/29/2014 DCH-OIGSummary Suspension
Miller David Home Help Grand Rapids 2/20/2018 MDHHSMiller Joyce Home Help Madison Heghts 12/15/2015 MDHHSMiller Lloyd Livingston Physician Livonia 4301047699 2/9/1989 HHS 1128(b)(3)
Miller Ross David Physician 1720086226 Hillsdale 4301056697 4/23/2010
Miluk Paul R. Physician 1336139740 Niles 5101010370 9/18/2013 DCHSummary Suspension
Miral Leon R. Physician Detroit 5101005657 5/26/1988 HHS 1128(a)(1)Miskell Eric Home Help Musegon 1/12/2017 MDHHSMitchell Chatondra Home Help Detroit 4/19/2018 MDHHSMitchell Ladarin Q Home Help Detroit 11/12/2014 DCHMitchell Marcella Home Help Detroit 7/8/2015 DCH
Mohamed Abdullahi A Physician 1013009000 Alpena 4301084848 5/18/2013
MI-Licensing and Regulatory Affairs 8/15/2013 DCH
TerminatedSuspended
Molett Reginald Home Help Pontiac 12/9/2015 MDHHSMonnan Syeed Home Help Warren 8/3/2017 MDHHS
Monteleone Melissa M. Nurse 1861439184 Huntington Woods 4704160940 11/8/2010
Moody Carthan Lagrant Dentist Kalamazoo 2901014263 1/20/2004 HHS 1128(a)(1)Moore Allen Home Help Saginaw 3/14/2016 MDHHSMoore Alisha Marie Home Help Warren 4/7/2015 DCHMoore Dannetta Marie Home Help Benton Harbor 6/10/2015 DCHMoore Kamitko Home Help Taylor 8/31/2017 HHS-OIGMoore Timothy Home Help Detroit 10/13/2014 DCH
Moret Rodney Physician 1851451819 Madison heights 4301064420 3/31/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Moret-Quezada Rodney Physician 1851451819Oak Park Madison Heights 4301064420 12/22/2015 DCH-HHS 3/31/2017 HHS
Summary Suspension Revoked
Morgan Hollis Home Help Benton Harbor 8/23/2016 MDHHSMorrell Javonda Home Help Lansing 6/17/2015 DCHMorris Jacqueline Home Help Kalkaska 4/5/2016 MDHHSMoser Carrie Home Help Davison 6/28/2017 MDHHS
Mosimbwa Charles Andrew Physician 1215134408 Berrien Springs 4301089193 3/12/2012
MI-Licensing and Regulatory Affairs Suspended
Moss Latonya Home Help Detroit 12/4/2014 DCHMoss Mitchell Home Help Detroit 6/25/2015 DCHMunn Karl Home Help Kalamazoo 4/25/2016 MDHHSMunshey Munir Ahmed Physician Ypsilanti 4301032297 9/11/1996 HHS 1128(a)(1)
Murphy Rosanne Physician 1245308790 Detroit 4301050350 7/30/2013
MI-Licensing and Regulatory Affairs Suspended
Murray Dwayne Home Help Lansing 2/20/2015 DCHMurrie Tommie Home Help Detroit 3/15/2017 MDHHSMurtuza Atiya Physician Centerline 4301042165 4/12/1993 HHS 1128(a)(1)
Myers Crystal Home Help Detroit 7/22/2015 MDHHS-OIG
Summary Suspension and Termination
Mynt Toe Physician 1982618138 Madison Heights 4301084986 7/9/2010
MI-Licensing and Regulatory Affairs Suspended
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Napier Luther Home Help East Pointe 1/19/2016 MDHHSNapier Tyrone Home Help Detroit 7/6/2015 DCHNash Elliott Home Help Kalamazoo 12/10/2014 DCHNash Johnathan l Home Help Detroit 4/27/2015 DCH
Nassar Lawrence Physician 1912011594 East Lansing 5101012213 2/7/2017 MDHHS-OIG
04/25/2017 1/24/2017 07/19/2017 4/20/18
Mi-Licensing and Regulatory Affairs MI Licensing and Regulatory Affairs HHS-OIG MDHHS-OIG
Revoked Suspended Suspended Excluded Terminated
Nasser Omar Home Help Sterling Heights 8/23/2016 MDHHSNavyac Debbie Home Help Madison Heights 6/13/2016 MDHHSNeal Robert Home Help Detroit 1/10/2017 MDHHSNeal Tiffany Home Help Lansing 7/25/2017 MDHHSNealy Stephen Lamar Home Help Eastpointe 11/30/2015 MDHHSNeeley Phillip Home Help Detroit 1/25/2017 MDHHS
Neely Richard Physician 1013908797 Durand 5101004783 9/18/2013 DCH10/18/2013 02/23/2017
DCH MI- Licensing and Regulatory Affairs
Summary SuspensionTerminated Summary Suspension
Nelson Barbara G. Physician 1700981040 Eastpointe 4301041753 5/22/2013 OTHER STATE 6/6/2017
MI-Licensing and Regulatory affairs
Voluntarily Surrendered Summary Suspended
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Nelson Christopher S. Physician 1922041615 St. Joseph 4301090162 9/29/2007
MI-Licensing and Regulatory Affairs
Summary Suspension
Nelson Patrick Home Help detroit 5/24/2016 MDHHSNelson Roger Wayne Chiropractor Pontiac 2301006600 10/10/1995 HHS 1128(b)(14)Nelson Ronnie Home Help Kalamazoo 5/5/2016 MDHHSNelson Tekeshon Home Help Grand Rapids 2/2/2016 MDHHS
Neri, Jr. Jesus C. Physician 1730109539 Rogers City 4301045742 4/4/2016
MI-Licensing and Regulatory Affairs 5/18/2016
MI-Licensing and Reegulatory Affairs
Summary Suspension Volunmtarily Surrendered
Nesbitt Gregory Home Help Oak Park 11/14/2017 MDHHSNeves Ekra Home Help Detroit 11/10/2014 DCH
Newhall Stanley Physician 1295969251 Salt Lake City , UT 4301040499 7/30/2016
MI-Licensing and Regulatory Affairs Suspended
Newton Jermaine Home Help Detroit 6/10/2015 DCHNichols Rachel A Home Help Owosso 5/19/2015 DCH
Nicholson III Robert M. Physician 1447225347 Kalamazoo 4301046860 1/17/2018
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Nix Edna Home Help Detroit 11/17/2016 MDHHSNorman eric Home Help Detroit 1/10/2018 MDHHSNorman Joseph Home Help Auburn Hills 1/14/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Norris Larry Chiropractor 1669529012 Portage 2301006036 7/13/2012
MI-Licensing and Regulatory Affairs Suspeneded
North John L. Optometrist 1932152105 Stevensville 4901002176 4/21/2018
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Nosal Leonard Dentist 1427254069 White Lake 2901011174 7/20/2004 HHS 1128(a)(4)Notley Jammie L Home Help White Cloud 11/5/2014 DCHNwankwo Portia Home Help Detroitq 5/17/2017 MDHHS
Nwoke Peter R. Physician 1841398955Gross Pointe Woods 4301082666 9/30/2012
MI-Licensing and Regulatory Affairs
10/26/2016 1/20/2013
MI- Licensing and Regulatory Affairs HHS
Suspended Excluded Suspended
Obert Amy B. Registered Nurse 1427371210 Grand Rapids 4704236200 10/7/2011
MI-Licensing and Regulatory Affairs
Summary Suspension
Odinma Moses Home Help Detroit 11/19/2016 MDHHSOdle Richard Home Help Ithaca 2/12/2015 DCH
Oesterling Joseph E Physician 1538136353 Saginaw 4301063677 12/9/2016
MI-Licensing and Regulatory Affairs
2/13/2017 01/17/2018
MDHHS-OIG MI-Licensing and Regulatory Affairs
Suspended Summary Suspension Suspension
Ojaniemi Leland Home Help Battle Creek 7/26/2016 MDHHSOjeda Angela Home Help Southfield 8/2/2017 MDHHSOliver Ashley L Home Help Lansing 11/26/2014 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
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)
Osterhout Ann Home Help Bay City 7/18/2016 MDHHS-OIG 6/29/2017 MDHHS-OIGSuspended Terminated
Ostrand Mary Home Help Snover 2/8/2018 MDHHSOwens Cornelius Home Help Saginaw 10/31/2017 MDHHSOwens Kristina Home Help Detroit 2/10/2016Palmer Kathy Home Help Saginaw 6/27/2017 MDHHSPamatmat Adelfo N Physician 1285676734 Detroit 4301034892 7/30/2013 DCH-OIG SuspendedPannell Larjuan Home Help Detroit 1/17/2017 MDHHS
Pannu Baljinder S Physician 1518011451 Oak Park 4301066542 9/5/2012
MI-Licensing and Regulatory Affairs Suspended
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Papendick Cynthia JNurse Practicitioner 1366423899 Union Pier 4704169270 10/4/2017
MI-Licensing and Regulatory Affairs
Pappas Spilios Physician 1649202250 Detroit 4301052677 11/12/2017 MDHHS-OIGSummary Suspension
Pappas William John Home Help Madison Heights 12/23/2014 DCH
Park James Physician 1144258971 Owosso 4301024053 8/4/2010
MI-Licensing and Regulatory Affairs
Criminal Conviction
Parker Amanda Home Help Detroit 3/15/2016 MDHHSParker Antoine Home Help Detroit 10/29/2016 MDHHSParker Johnnie Home Help pontiac 1/18/2018 MDHHSParkhurst Laura Home Help Carrolton 4/26/2015 MDHHSParis Rashaan Home Help Detroit 4/18/2017 MDHHSParrett Sarah Home Help Kalamazoo 8/11/2015 MDHHS
Patel Arvind Physician 1437217601 Detroit 4301034282 7/4/2016 MDHHS1/9/2017 04/20/2017
PatelSuman (chandra) Pysician 1790773729 Wayne 4301406326 2/10/2015 DCH-OIG
Summary Suspension
Patrick Mark Home Help Detroit 4/11/2016 MDHHSPatrick Michelle Home Help Detroit MDHHSPatterson Andre Home Help Detroit 7/21/2016 MDHHSPatterson Steve Home Help Hastings 6/29/2017 MDHHS
Paupore Joseph Thomas Physician 1841285467 Livonia 5101012057 4/21/2008
MI-Licensing and Regulatory Affairs
License Revocation
Payea Richard Paul Physician 1124019674 East Tawas 4301047848 9/2/2009
MI-Licensing and Regulatory Affairs Suspended
Payne Laron Home Help Battle Creek 3/23/2017 MDHHSPayne Ulie Home Help Lansing 12/23/2014 DCHPayton Christopher Home Help Detroit 12/20/2017 MDHHS
Pearce Edwin T. Physician 1114977618 Clinton Township 4301021837 10/7/2008
MI-Licensing and Regulatory Affairs
Summary Suspension
Pearson Sarah Home Help Grand Rapids 7/14/2016 MDHHSPeeples- Jones Angela Home Help Westland 9/26/2017 MDHHSPeneger Kevin Home Help Flint 4/18/2016 MDHHSPennell Alan Home Help Idlewild 11/30/2015 MDHHSPeoples Leonora Home Help Detroit 9/18/2015 MDHHSPerkins Kim Home Help Port Huron 10/11/2016 MDHHSPerkins Yvette Home Help Detroit 4/12/2018 MDHHSPeterson Dwight Home Help Highland Park 9/21/2017 MDHHSPetipren David J. Dentist Capac 2901008794 6/13/1990 HHS 1128(b)(4)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Petroelje Glenn E. Dentist Holland 2901007127 7/28/1986 HHS 1128(a)(1)
Pettiway Willie Physician 1275669293 Detroit 4301049323 7/14/2016
MI-Licensing and Regulatory Affairs 3/31/2017
Mi- Bureau of Licensing and Regulatory Afffairs
Summary Suspension
Perez Gilberto Home Help Grand Rapids 2/23/2017 MDHHS Pfeifer Lauren Joan Physician Caro 4301056619 5/20/2004 HHS 1128(b)(4)Philip Pinkie HomeHelp Detroit 11/30/2017 HHS-OIGPhillips David Chaffee Physician Allegan 4301046887 3/20/2003 HHS 1128(b)(4)Phillips Jonathan Home Help Grand Rapids 10/13/2014 DCHPhillips Shirley Home Help Benton Harbor 11/30/2015 MDHHS
Pickens Jr Alex Physician 1649226507 Detroit 4301038348 8/23/2017 MDHHS-OIGSummary Suspension
Piechocki Joseph J Physical Therapy 1548370034 Macomb Twp 5501004900 5/27/2017
MI-Licensing and Regulatory Affairs Suspended
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Pitts Joseph A. Physician Detroit 5101006636 10/18/2001 HHS 1128(b)(15)Pitts Mark Home Help Detroit 7/17/2017 MDHHSPleasants Maurice Home Help Detroit 4/6/2017 MDHHS
Plucer, Mark G., DO, PC Plucer Mark G. Physician Group Flint 5101006481 9/13/2002 DCH 1/20/2003 HHS
9/13/02: Violation of Medicaid False Claim Act1/20/03: 1128(a)(1)
Polk Alphonozo Home Help Flint 2/13/2017 MDHHS
Pompy Lesly Physician 1174578801 Monroe 4301058720 8/4/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Ponce Fernando Chiropractor 1669681508 Lansing 2301005828 5/28/2008
MI-Licensing and Regulatory Affairs
License Revocation
Poole Portia Home Help Detroit 3/15/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
PornpichitSethavarangura Physician Detroit 4301033113 9/27/2007 DCH
Summary Suspension
Porter Alexis Home Help Detroit 2/9/2017 MDHHSPorter James Home Help Battle Creek 7/20/2017 MDHHSPorter Leroy Home Help Detroit 11/30/2015 MDHHS
Harbor Medical Diagnostic Clinic, Inc. Povlitz Robert H. Physician Group Keego Harbor 4/11/1991 HHS 1128(a)(1)
Powell Robert Home Help Clinton Township 9/19/2017 MDHHS
Prais Maureen CRNA 1497792717 Manchester 4704102142 6/1/2016
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Premeau john Home Help MArquette 8/2/2017 MDHHSPrice Calvin U. Physician Flint 5101004559 7/22/1991 HHS 1128(a)(1)Price Tony Home Help Detroit 2/20/2015 DCH
Proctor Vernon Physician 1225215783 Baldwin 4301089365 12/30/2017
MI-Licensing and Regulatory Affairs
Disciplinary Limited License
Proby Keith Home Help Muskegon 4/28/2015 DCHPruitt Marcel Home Help Detroit 3/7/2016 MDHHS 12/13/2017 MDHHSPuente Karen A Home Help Melvindale 1/26/2015 DCHPugh Henry Home Help Detroit 7/21/2016 MDHHSPugh timothy Home Help Burr Oak 5/3/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Pullen Kenneth Home Help Detroit 12/18/2014 DCHPullian Yuolanda E Home Help Benton Harbor 12/5/2014 DCHPurnell Linda Home Help Mount Morris 12/14/2015 MDHHS
Detroit Plaza II Pharmacy Pylar George Pharmacy Detroit 5301003640 6/8/1988 HHS 1128(b)(3)
Glendale Pharmacy Raval Vijay Kumar Pharmacy 1366765083 Highland Park
NCPDP 2373809 8/19/2011 DCH 7/11/2016 MDHHS-OIG
Summary Suspension Termination
Ray Marquetta Home Help Detroit 3/29/2016 MDHHSRedd Clara C Home Help Allen Park 1/28/2015 DCHReed David Home Help Detroit 11/21/2016 MDHHSReed Lawanda Lorena Home Help Grand Rapids 12/15/2014 DCHReid Jaronn Home Help Taylor 6/5/2017 MDHHSReid John Andrew Home Help Canton 3/16/2015 DCHReid Larry Home Help Detroit 12/19/2016 MDHHS
Reyes Janice Renee Home Help Detroit 11/30/2015 MDHHSReynolds Don Home Help Detroit 12/7/2017 MDHHSReynolds January Home Help Grand Rapids 6/8/2017 MDHHSReynolds Stacey Home Help Pontiac 11/9/2017 MDHHS
Reznick Terry Physician 1295874451 Fenton 5101009942 4/20/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Ribbentrop Paul H. Physician St. Clair Shores 5101003921 5/20/2003 HHS 1128(a)(4)Richard Lawrence B. Podiatrist 1972565448 Northville 5901001176 4/19/2015 HHS Excluded Richardson Angela Home Help Detroit 9/20/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Richter William H. Dentist 1386762805 Saginaw 2901010083 9/6/2017
MI-Licensing and Regulatory Affairs
Limited Restricted License
Richardson Neil James Chiropractor Grand Rapids 2301006727 7/6/1997 HHS 1128(b)(14)Richardson Rhonda Home Help benton harbor 1/25/2018 MDHHSRiddle Edward Home Help Kalamazoo 2/16/2017 MDHHSRiley Shandell Lapep Home Help Grand Rapids 4/6/2015 DCH
Ringley Pamela Ann Nurse Practitione 1134539281 Howell 4704165210 9/8/2015
MI-Licensing and Regulatory Affairs
Summary Suspension
Robart Nicole Home Help Muskegon 12/18/2017 MDHHSRoberts Patrick Home Help Detroit 10/24/2016 MDHHSRoberts-Bey Wesley Home Help Flint 11/18/2014 DCHRobertson Antoine Home Help Detroit 5/31/2016 MDHHSRobinson Arthur Home Help Detroit 2/15/2016 MDHHS
Care for U Medical Clinic, PC Robinson Cynane Owner 1386712503 Bloomfield 12/20/2001 HHS Excluded
Robinson Donald Home Help Detroit 9/21/2016 MDHHSRobinson Harold Home Help Southfield 8/2/2017 MDHHSRobinson Kinte Home Help Ypsilanti 1/2/2018 MDHHSRobinson Laurence Home Help Detroit 2/24/2015 DCH 1/30/2018 MDHHSRobinson Philip Home Help Detroit 8/31/2015 MDHHSRobinson Phyllis Home Help Port Huron 4/19/2018 MDHHSRobinson-Crowell D'ett L Home Help Roseville 2/24/2015 DCHRoby Thomas Home Help Detroit 10/29/2016 MDHHSRochefort Rocky Home Help Oscoda 5/17/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Roe-Carney Treka Home Help Clarkston 6/11/2015 DCHRogers Dione Home Help Detroit 4/19/2016 MDHHSRojas Humberto Physician Owosso 4301044894 10/20/2002 HHS 1128(a)(4)Rollins Jerry Home Help Highland Park 5/17/2017 MDHHSRollins Jawanne J Home Help Detroit 11/3/2014 DCHRollins Kevin Home Help Detroit 10/13/2014 DCHRone Jimmy Home Help Muskegon 1/9/2015 DCHRone Alvin D Home Help Muskegon Heights 11/30/2015 MDHHS 3/12/2018 HHS-OIGRosa Blanca Home Help Detroit 9/18/2017 MDHHSRose Edward Allen Physician 1750354106 Novi 4301046183 10/31/2013 HHS 1128(b)(4)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 Guy Home Help Detroit 11/2/2016 MDHHS
Roth Michael A Physician 1396893061 Famington Hills 4301028327 8/9/2016 MDHHS-OIG 10/13/2017
MI-Licensing and Regulatory Affairs
Summary Suspension Suspended
Roth Steven J Physician 1538123609 Waterford 5101006341 11/4/2017
MI-Licensing and Regulatory Affairs Suspended
Roumayah Najah Dental Group 1255419958 West Bloomfield 8/15/2017 MDHS-OIGSummary Suspension
Rouser Cherrie Home Help Lansing 11/12/2016 MDHHSRoy Tracie L Home Help Baldwin 1/30/2015 DCHRucker Demetrious Home Help Detroit 9/24/2015 MDHHSRuffin Leonard Home Help Detroit 7/10/2015 DCH 4/18/2018 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Runyon Betty Lou Home Help Whittemore 5/31/2017 MDHHSRussell Carlesia HomeHelp Pontiac 11/8/2017 MDHHS
Trio-Camburn Drugs Russell James W. Pharmacy Flint 4/20/1998 HHS 1128(b)(1)
Russell Jeffrey S Physician 1497799654 Coldwater 5101011799 1/27/2015
MI-Licensing and Regulatory Affairs Suspended
Russell Renarad E Home Help Adrian 12/12/2014 DCHRutherford John W. Physician River Rouge 5101005008 7/24/1986 HHS 1128(a)(1)Ryans Carla HomeHelp Prudenville 2/15/2018 MDHHSRyans Larry Home Help Saginaw 11/5/2014 DCH
Sabit Aria Physician 1659510972 Southfield 4301097955 3/10/2015 DCH-OIG4/19/2015 04/26/2017
HHS-OIG MDHHS-OIG
Summary Suspension Excluded Terminated
Sadeghi Azar Home Help Ann Arbor 8/29/2017 MDHHSSaeed Jalal Home Help Dearborn 4/22/2015 DCHSaleh 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 MDHHSSamuel Tyrus Phillip Home Help Eastpointe 4/9/2015 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Sanchez Christina Louise Home Help Perrinton 10/20/2014 DCHSanders Jarett Home Help Detroit 9/29/2015 MDHHSSantana Henry Home Help Detroit 7/27/2017 MDHHSSantos 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)
Saperstein Glenn S Physician 1770637670 Commerce Township 5101011716 2/1/2017
Schultz Yvonne Home Help Port Huron 9/16/2015 MDHHSSchupback Tara Home Help Bay City 11/3/2017 MDHHS
Schutte NataliePhysician Assistant 1295982189 Mount Pleasant 5601005332 2/22/2012 DCH 8/7/2013 DCH
TerminatedSuspended
Schwartz Gary J. Chiropractor 1326249624 Jackson 2301002137 6/8/1994 DCH
Violation of Medicaid False Claim Act
Schwarz Bernard C. Chiropractor 2301005101 12/7/1994Scott Dante J Home Help Muskegon 1/14/2015 DCHScott Eliza Home Help Zeeland 3/15/2016 MDHHSScott Karla Jean Home Help Benton Harbor 6/17/2015 DCHScott Karley Home Help Roseville 6/28/2017 MDHHSScott Mary Home Help Detroit 6/17/2015 DCHScott Terry Junior Home Help Bangor 5/15/2015 DCH
Scott Van Edward Physician 1164575031 Muskegon Heights 4301044463 1/10/2014 DCH-OIG 2/9/2014 DCH-OIG
1/10/14 Summarily Suspended2/9/2014 Terminated
Scott Ricky Home Help Detroit 11/30/2015 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Scranton Steven E Physician 1578543476 Grand Rapids 4301043798 3/5/2018 MDHHS-OIG 3/23/2018
MI-Licensing and Regulatory Affairs
Summary Suspension Summary Suspension
Seavy Dawn Home Help Lansing 8/19/2015 MDHHSSelf Freeman Home Help Detroit 1/18/2017 MDHHSSenior Duane A. Dentist 1841354545 Detroit 2901014215 2/5/1997 HHS 1128(b)(14)
Sherman, Errol DPM PC Sherman Errol Podiatrist 1770507147 Oak Park 5901000864 4/27/2011
MI-Licensing and Regulatory Affairs 6/9/2015 DCH - OIG
Summary Suspension Terminated
Sherman Matthew Home Help Ferndale 10/25/2017 MDHHSShields Siobham Home Help Grand Rapids 12/15/2015 MDHHSSholes Carlton Home Help Alpena 4/16/2018 MDHHSShort Gary Home Help Hart 9/29/2017 MDHHS Shufford Luvenia Home Help Kenosha 12/15/2014 DCHSims Arlester Home Help Muskegon 8/4/2016 MDHHS
Siebert John W. Physician 1063594521 Madison, WI 50002 6/13/2013 Other State
Suspension by the State of New York
Sigger Menard Home Help Detroit 7/14/2016 MDHHS
Silber Alan Physician 1366447260 West Bloomfield 4301085080 6/20/2011
MI-Licensing and Regulatory Affairs
Summary Suspensions
Simila Denise Home Help MArquette 3/8/2018 MDHHS
Simmons KimNon Emergency Transportation Detroit 12/14/2017 MDHHS
Simmons Tara Wokeim Home Help Detroit 11/26/2014 DCHSimon Elvea Home Help Detroit 11/17/2017 MDHHSSimpson Lonnie Home Help Detroit 5/3/2017 MDHHSSimpson James Vernon Dentist St. Helen 2901015390 11/8/1994 HHS 1128(b)(3)
Singh Kumar A Physician 1679744395 Troy 5101017054 6/26/2017
MI-Licensing and Regulatory Affairs 2/23/2018
MI-Licensing and Regulatory Affairs
Summary Suspension dissolved Suspended
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Skinner Charelene Home Help Lansing 5/19/2015 DCH-OIGSummary Suspension
Skinner Michael W Home Help Lansing 3/10/2015 DCHSklar Eugene Dentist Gaylord 2901008434 11/4/1990 HHS 1128(b)(4)Slusher Stephen L. Chiropractor Escanaba 2301007042 1/20/2003 HHS 1128(a)(4)Smakal Gary Home Help Lake George 4/29/2015 DCHSmereck Karen Lynne Dentist 1316026917 Allen Park 2901016800 10/20/2004 HHS 1128(a)(1)Smith Alice Home Help Detroit 4/16/2018 MDHHSSmith Antonio Home Help Detroit 12/17/2015 MDHHSSmith Bobby Home Help Detroit 10/28/2015 MDHHS
Smith Dwight E. Physician 1114942562 Detroit 4301046520 5/29/2012 DCHSummary Suspension
Smith Eric Home Help Detroit 10/31/2017 MDHHSSmith Franzora Home Help Detroit 12/15/2014 DCHSmith Gregory Andre Home Help Detroit 5/18/2015 DCHSmith Jamila Home Help Detroit 12/22/2015 MDHHSSmith Jennie Home Help Pontiac 3/9/2016 MDHHSSmith Joe Home Help Saginaw 3/25/2015 DCHSmith Kauba Home HelpSmith Kyron Home Help Inkster 3/8/2018 MDHHS
Smith Margaret S CRNA 1912003195 Brownstown 4704103015 7/9/2015
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Smith Michael Home Help Jackson 10/31/2017 MDHHSSmith Mirthus T Home Help Newport 11/30/2015 MDHHSSmith Raelynn Home Help Grand Rapids 2/20/2015 DCHSmith Ray Home Help Farwell 5/26/2015 DCHSmith Robert Home Help Hastings 2/16/2017 MDHHSSmith Shannon Home Help East China 9/14/2016 MDHHSSmith Sandra Home Help Beaverton 1/25/2016 MDHHSSmith Stevonna Home Help Detroit 4/4/2017 MDHHSSmith Tandre Home Help Flint 6/27/2016 MDHHSSmith Thomas E Home Help Detroit 11/30/2015 MDHHSSmith William Lee Home Help Detroit 11/30/2015 MDHHSSmith Yvette Home Help Grand Rapids 1/28/2017 MDHHSSnyder Jonathan Home Help Kalkaska 8/29/2017 MDHHSSnyder Richard E. Physician Detroit 5101009381 12/18/1997 HHS 1128(b)(4)
Sokoll William C Physician 1639181753 Standish 4301046279 5/6/2014 DCH-OIG 9/20/2017 HHS-OIG
Summary Suspension Exclusion
Soliman Mikhayl Physician 1356536460 Wayne 4301086758 7/3/2013 DCH-OIG Suspended
Spears Dersell Home Help Detroit 1/9/2018 MDHHSSpeed Kenneth Home Help Lansing 11/30/2015 MDHHSSpeller Kevin S Home Help Ecorse 2/13/2015 DCHSripinyo Veera Physician Warren 4301031589 5/6/1997 HHS 1128(b)(4)Stachulski Holly C Home Help Taylor 4/20/2017 HHS Excluded
We Care Living Enrichment Center, Inc. Stacy Marcia SA Treatment Saginaw 30128 7/20/1999 HHS 1128(a)(1)
St. Amor Stephen Home Help Romulus 12/2/2015 MDHHS 1/6/2016Suspended Terminated
Stanford Donna Home Help Southfield 11/5/2014 DCHStanford Kemonta Home Help Detroit 10/3/2017 MDHHSStang Robert Martin Physician Monroe 5101012881 10/19/2006 HHS 1128(a)(2)Starks Jodie Home Help Detroit 5/6/2015 DCHStarks Ladonna Home Help Highland {Ark 12/15/2016 MDHHSStarks Sandra Home Help Kalamazoo 5/19/2015 DCHStarr Veronica Home Help Warren 2/11/2014 DCH-OIG 7/1/2015 MDHHS-OIG TerminatedStatler Erin Home Help St. Joseph 9/14/2016 MDHHSSteele Coszetta Home Help Jackson 4/27/2015 DCHStephens Dontrail Dwayne Home Help Benton Harbor 10/19/2015 MDHHSSterling Precious Ebony Home Help Benton Harbor 6/10/2015 DCHStetz Michael N. Chiropractor Lansing 2301006648 4/20/2003 HHS 1128(a)(3)
Stevenson Vernon R Physician 1760579395 Ypsilanti 4301061583 3/31/2017
MI-Licensing and Regulatory Affairs
Disciplinary Limited License
Steward Travis Home Help Detroit 11/24/2014 DCHStewart Frederick Home Help Saginaw 9/29/2015 MDHHSStewart Ronald Home Help Detroit 1/30/2015 DCHStewart Tequila Home Help Grand Rapids 8/5/2015 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Stringfellow Terry Home Help Dearborn Heights 3/12/2018 MDHHSStrouse Kim Home Help Grand Rapids 2/8/2017 MDHHSStrugach Vitality Home Help West Bloomfield 9/21/2016 MDHHS
Stuenkel Terri M Physician 1568511426 Deckerville 5101012732 10/24/2015
Taliaferro Maurice Home Help Kalamazoo 5/19/2016 MDHHSTansil Ginger M Home Help Kent City 3/12/2015 DCHTapert 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 DCHTatum Michael Lawrence Home Help Detroit 11/30/2015 MDHHSTaylor 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 MDHHSTaylor Jimmie Home Help Detroit 1/11/2018 MDHHSTaylor Rashad Home Help Detroit 2/27/2017 MDHHS
Taylor Roosevelt Physician Flint 5101004568 6/28/1992 HHS 1128(b)(3) Taylor Robert Home Help Detroit 2/5/2018 MDHHS
Temple Frederick Home Help Saginaw 6/17/2015 DCHTerrell Gregory Home Help Eastpointe 1/12/2017 MDHHSTerrell Jose Home Help Southfield 4/9/2018 MDHHSTerry Antonio Home Help Detroit 1/15/2015 DCHTerry Maurice Home Help Detroit 4/11/2016 MDHHS
Thielman Michael Physician 1881722239 Stevens Point, WI 38131-02 3/9/2018 Other States
Suspended in NV and Revoked in IL
Thepveera Kraingsak Physician 1922167246 Saginaw 4301032947 12/6/2016 MDHHSTherrien Jeremy Home Help Escanaba 5/19/2016 MDHHSThomas Donald Home Help Sterling Heights 4/16/2018 MDHHSThomas Keyanna M Home Help Saginaw 11/20/2014 DCHThomas Tawana Home Help Muskegon 12/17/2015 MDHHSThomas Terry Home Help Detroit 6/15/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Thomas Timothy M Chiropractor 1205909660 Southgate 2301005050 8/25/2016
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Thomas Tony Lamar Home Help Detroit 5/22/2015 DCHThomas Tonyetta Home Help Niles 11/30/2015 MDHHSThompkins Kenneth Home Help Detroit 3/16/2018 MDHHSThompson Andre K Home Help Flint 11/30/2015 MDHHSThompson Audry Gale Home Help Detroit 4/1/2015 DCHThompson Harrel Home Help Mt Clemens 10/17/2016 MDHHSThompson Robert Eugene Physician 1447399720 Alpena 4301071670 12/20/2009 HHS 1128(b)(4)Thornton Mario Home Help Sterling Heights 4/10/2018 MDHHSThurman Deborah Home Help Detroit 12/1/2014 DCHThurman Leory Home Help Lansing 5/1/2017 DHHS
Tika Lovin Home Help Macomb Township 7/20/2015 DCHTillery Terrence Home Help Detroit 11/16/2015 MDHHS
Tipton Patricia Home Help Flint 6/8/2015 DCH-OIG
Suspended and Terminated
Tobias Angela Home Help Port Huron 5/11/2017 MDHHS`Tisdell Craig Home Help Bentoin Harbor 9/9/2015 MDHHSTocco Peter Physician Pontiac 5101006837 3/8/1994 HHS 1128AaTolbert Jesse Home Help Iron Mountain 3/8/2018 MDHHSToles Marchetta Home Help Redford 1/17/2018 MDHHS Tolton Shirley Home Help Detroit 9/15/2016 MDHHSTombo Jose M. Physician Detroit 4301033662 1/10/1991 HHS 1128(b)(4)Toronjo Betty Home Help Midland 5/4/2017 MDHHSTossa Edward Home Help Warren 11/7/2016 MDHHSTownsend Gary Home Help Otsego 3/28/2016 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Trepanier Carol Dentist 1932265899 Detroit 2901016776 5/21/2010
MI-Licensing and Regulatory Affairs Suspended
Trevino Esther Home Help Pontiac 4/18/2017 MDHHSTrosclair Wanda Home Help Sault Sainte Marie 12/20/2017 MDHHSTrotter Alice Home Help Lansing 10/28/2015 MDHHSTrotter Anthony Home Help Grand Rapids 9/15/2016 MDHHS
Trotter Johnny Ray Physician 1548441058 Bloomfield Hills 4301091131 2/14/2018
MI-Licensing and Regulatory Affairs
Summary Suspension
Trowell Lawrence Home Help Detroit 5/4/2016 MDHHSJordan Clinical Laboratory Truss Thomas Laboratory Detroit 11/15/1986 HHS 1128(a)(1)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Tunis Jonathan D. Physician Carson City 4301065350 3/20/2000 HHS 1128(b)(4)Turner Angela Home Help Muskegon 1/6/2016 MDHHSTurner Tamon Terrance Home Help Benton harbor 11/24/2014 DCH
Tuttle Douglas KPhysician Assistant 1699708875 Walker 5601001502 6/29/2017
MI-Licensing and Regulatory Affairs
Summary Suspension
Ucer Erol Physician Flint 4301031131 6/4/1995 HHS 1128(b)(1)Umphrey Samantha Home Help Alger 1/14/2017 MDHHSUithol Winifred Home Help Gladwin 11/30/2015 DCH
Urbanik Michael S. Dentist Detroit 2901013979 5/6/2003 DCH 5/20/2013 DCH-OIG
5/6/03: Violation of Medicaid False Claim Act5/20/03: 1128(a)(1)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Vaccaro Victoria ANurse Practitioner 1609974112 Adrian 4704150960 8/27/2015
MI-Licensing and Regulatory Affairs
Summary Suspension
Vaid Mustak Y. Physician 1982619649 Livonia 4301085038 9/26/2011 DCH 2/11/2016 MDHHS-OIG
Summary Suspension Terminated
Valdez Jose V. Physician Detroit 4301030159 9/2/1997 HHS 1128(b)(2)Vallad Randall Home Help Hersey 6/28/2017 MDHHSVance Robert Home Help Benton Harbor 2/22/2017 MDHHS
Vance Sarah A Registered Nurse 1497000269 Belleville 4704241489 1/21/2016
MI-Licensing and Regulatory Affairs
Summary Suspension
Van Der Weide Arie Physician 1679512966 Fremont 5101010310 1/19/2009
MI-Licensing and Regulatory Affairs
Summary Suspension
Van DeVusse Jamie Counselor 1417385733 Wyoming 6401013974 9/8/2017
MI-Licensing and Regulatory Affairs Suspended
Vanner Kenneth Home Help Inkster 1/10/2018 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Vargas Dominic Home Help Onaway 4/7/2015 DCHM & M Pharmacy, Inc. Varner Maggie Pharmacy Detroit 5301004011 6/13/1990 HHS 1128(b)(1)Savco Pharmacy, Inc. Varner Maggie Pharmacy Detroit 5301004595 6/13/1990 HHS 1128(b)(1)
Vartapev Alexander Home Help Hamtramck 4/7/2015 MDHHSVaughn Paul Home Help Hastings 2/16/2017 MDHHSVelez-Ruiz Wanda Enid Physician 1023123858 West Bloomfield 4301045752 1/17/2009 DCH 8/10/1994 Suspended
Velez-Ruiz Wanda E. Physician 1023123858 Detroit 4301045752 11/10/1993
MI-Licensing and Regulatory Affairs
11/10/93: Violation of Medicaid False Claim Act8/10/94: 1128(a)(1)
Verbovsky John R Physician 1528171774 Southfield 5101006690 3/10/2015 DCH-OIG
4/17/2015 12/14/2015 05/19/2016
MI-Licensing and Regualtory Affairs MDHHS- OIG HHS-OIG
Vernia Dawn Home Help Battle Creek 2/8/2016 MDHHS 2/8/2016 MDHHSVillarta Antonio Q. Physician Adrian 4301033470 2/20/2001 HHS 1128(b)(4)Vineyard Robert Home Help Saginaw 6/29/2017 MDHHS
Responsible Care Pharmacy Virabhai Patel
Chetan Gujarathi/ Pharmacy 1861668089 Detroit
NCPDP 2371160 8/19/2011 DCH 5/23/2016 MDHHS-OIG
Summary Suspension Termination
Vlcko Peter B. Physician Oak Park 5101009612 6/4/1995 HHS 1128(a)(2)Vogel Peter Home Help Dimondale 12/5/2017 MDHHSVonhatten Amber Home Help Ypsilanti 1/31/2018 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Vora Kandarp K Physician 1023119898 Gladwin 4301037407 1/20/2016
MI-Licensing and Regulatory Affairs 11/30/2016 HHS-OIG
Excluded Voluntarily Surrendered
Vorhies Paul E CRNA 1740246578 Scottville 4704103969 11/8/2012
MI-Licensing and Regulatory Affairs
Voluntarily Surrendered
Wagner John R Physician 1396737086 Warren 4301061192 7/16/2012
MI-Licensing and Regulatory Affairs Suspended
Wagner Gwendolyn Home Help Detroit 11/30/2015 MDHHSWaldron Teddi Irene Home Help Jackson 4/14/2015 DCHWalker Adrian Home Help Inkster 2/17/2016 MDHHSWalker Armond Home Help Farmington Hills 4/17/2018 MDHHSWalker Cory Home Help Westland 3/8/2018 MDHHSWalker LaShawandra Home Help Muskegon 1/6/2016 MDHHSWalker Latonya Home Help Detroit 5/13/2015 DCHWalker Tangia Home Help Detroit 1/13/2016 MDHHS
Dr. Waltz Denture Service Waltz Robert I. Dental Group Beaverton 2901006537 9/5/2002 DCH 9/19/2002 HHS
09/05/2002 Violation of Medicaid False Claim Act09/19/2002 1128(a)(1)
Warren Eric Home Help Detroit 2/14/2018 MDHHSWarren Linda F. Home Help Detroit 11/30/2015 MDHHSWarren Misty Home Help Detroit 6/26/2017 MDHHSWarrens Shareese Home Help Grand Rapids 11/19/2016 MDHHSWashington Alonzo HomeHelp Lansing 11/14/2015 MDHHSWashington Anthony Home Help Ecorse 12/4/2014 DCHWashington Antwone Home Help Detroit 3/13/2017 MDHHSWashington Ervin Home Help Saginaw 11/24/2014 DCHWashington Herman L Home Help Hesperia 3/5/2015 DCHWatkins Keon Home Help Redford 7/13/2016 MDHHSWatkins Kelli Home Help detroit 10/24/2016 MDHHSWatkins Shannon Home Help Muskegon 8/27/2015 MDHHSWatson Linda Home Help Port Huron 11/17/2016 MDHHSWatson Paula Home Help Midland 10/13/2017 MDHHSWatts Alonzo Home Help Detroit 1/25/2016 MDHHS
Watts Samuel G. Physician Detroit 4301030543 3/18/1987 DCH
Violation of Medicaid False Claim Act
Weatherspoon Derick Home Help Flint 12/17/2014 DCHWeaver Latonya Home Help Pontiac 8/23/2016 MDHHSWebb Divana Home Help Detroit 9/15/2015 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Wesley Jake Home Help Detroit 5/8/2015 DCHWessels David Home Help Harbor Beach 11/30/2015 MDHHSWest 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-Ware Keela Home Help Battle Creek 6/30/2015 DCHWheaton Rudolph D. Dentist Flint 2901011646 8/6/1997 HHS 1128(b)(4)
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Wheeler Shannon Home Help Pontiac 2/22/2016 MDHHSWhitaker Jelekeco Home Help Detroit 9/14/2016 MDHHSWhitby Milton Home Help Wyoming 10/18/2014 DCHWhite Bernard Torrell Home Help Detroit 11/30/2015 MDHHSWhite Brian Home Help Redford 12/13/2016 MDHHS
White Daniel D. Dentist Grand Rapids 2901011156 10/8/1999 DCH 10/20/2002 HHS
10/8/1999 Violation of Medicaid False Claim Act10/20/2002 1128(a)(1)
White John Arthur Dentist 1407066244 Detroit 2901012365 1/11/2008
MI-Licensing and Regulatory Affairs
License Suspended
White Lamount Home Help Detroit 10/19/2016 MDHHSWhite Mitchell Home Help River Rouge 3/14/2016 MDHHSWhite RAYMOND Home Help Lansing 11/27/2017 MDHHSWhite Renee Home Help Detroit 12/15/2015 MDHHS
Whitemore Ronald Home HelpCommerce Township 9/22/2015 MDHHS
Whiteside Magalena Home Help Muskegon 3/20/2017 MDHHS
Whiteus Timothy Physician 1174543342 Detroit 4301406556 7/30/2014 DCH-OIG
10/23/2015 12/14/2015 01/20/2016
MI-Licensing and Regulatory Afairs MDHHS-OIG HHS-OIG
Wilson Mardell Home Help Inkster 12/20/2016 MDHHSWilson Martez HomeHelp Detroit 11/30/2017 MDHHSWilcox Carlos Home Help Madison Heights 5/3/2017 MDHHSWindham Perrien Home Help Dertroit 12/13/2016 MDHHSWilliams Belinda Home Help Detroit 9/15/2015 MDHHSWilliams Benshamiel Home Help Detroit 1/18/2017 MDHHSWilliams Craig Home Help Detroit 10/4/2017 MDHHSWilliams Damron Michael Home Help Detroit 11/3/2014 DCH
Williams DerekNon Emergency Transportation Idlewild 4/6/2017 MDHHS
Williams Felicia Home Help Ludington 3/16/2015 DCHWilliams John T. Home Help Marion 11/12/2014 DCHWilliams Joey Home Help Flint 4/14/2016 MDHHSWilliams Kapone Home Help Lansing 2/18/2016 MDHHSWilliams Owina Home Help Detroit 11/30/2015 MDHHSWilliams Terina Home Help Detroit 1/25/2016 MDHHSWilliams Terina Home Help Detroit 9/16/2015 MDHHSWilliams William Home Help Detroit 9/7/2017 MDHHSWilliams Willie C Home Help Inkster 11/3/2017 MDHHS
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018
Woollams Stanley J. Physician Ann Arbor 4301023228 5/6/1996 HHS 1128(b)(4)Woooten Marquet Home Help Grand Rapids 3/30/2017 MDHHSWright Darrin Home Help Detroit 11/17/2016 MDHHSWright Johnny E Home Help Grand Rapids 11/30/2015 MDHHSWright Larry Home Help Detroit 12/26/2015 MDHHSWyatt Kimberly Home Help Wilson 6/21/2016 MDHHSWright Stacy Home Help Detroit 9/6/2016 MDHHSYancy Damian Home help Saginaw 8/17/2015 MDHHSYancy Mandy Home Help Coleman 3/27/2017 MDHHSYeo Judith Home Help Grand rapids 11/30/2017 MDHHSYouhan Randy Home Help West Bloomfield 4/28/2016 MDHHSYoung Arstell Home Help Warren 1/30/2015 DCH
Young GeorgeConrad-Spencer Chiropractor 1902953326 Munising 2301008758
03/01/2014 12/18/2014
DCH-OIG HHS
Summary Suspension Excluded
Young Ida Home Help Standish 6/21/2016 MDHHS
Young Lawrence Podiatrist 1881664498 Dearborn 5901000652 12/3/2017 MDHHS-OIGSummary Suspension
Young Michael Home Help Detroit 11/18/2014 DCH
Yousif Layla R Dentist 1831309228 Shelby Township 2901017121 2/19/2015
MI-Licensing and Regulatory Affairs Suspended
Zahoor Mohammed I Physician 1922096452 Novi 4301062300 10/15/2017 MDHHS-OIG
Summary Suspension
Zaragoza Carlos Home Help Saginaw 11/30/2015 MDHHSZeliasko Steven David Home Help Indian River 11/13/2014 DCH
Entity Name Last Name First NameMiddle Name
Provider Category NPI# City License#
Sanction Date1
Sanction Source
Sanction Date2
Sanction Source Reason
Medicaid Michigan Sanction Provider List April 25, 2018