Healthsource Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

HEALTHSOURCE INC

Practice address

4707 Saint Antoine St
Suite G20
Detroit, MI 48201-1427

Phone

(800) 543-0161

NPI assigned

May 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sabah Velasco

Title

Manager of Claims and Technology

Phone

(313) 966-8467

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003026709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44290",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482440290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 SAINT ANTOINE ST",
            "address_2": "SUITE G20",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011427",
            "telephone_number": "800-543-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VELASCO",
        "authorized_official_first_name": "SABAH",
        "authorized_official_title_or_position": "MANAGER OF CLAIMS AND TECHNOLOGY",
        "authorized_official_telephone_number": "313-966-8467"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.