Organization Active NPI

Henry Ford Medical Group Genesys

  • Family Medicine Physician
  • Mount Morris, MI
National Provider Identifier
1003398470
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HENRY FORD MEDICAL GROUP GENESYS
Practice address
4485 E Mount Morris Rd
Mount Morris, MI 48458-8963
Phone
(810) 424-2101
NPI assigned
Sep 3, 2018
Last updated
Apr 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Authorized official

Name
Kimberly Cebalt
Title
Director
Phone
(313) 874-6764

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

4485 E Mount Morris Rd
Mount Morris, MI 48458-8963

Mailing address

PO Box 670884
Detroit, MI 48267-0884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181002000367 MI Part B Supplier - Clinic/Group Practice 7214288281 Receives reassigned benefits from 108 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Blanc, MI; Goodrich, MI; Linden, MI; Millington, MI; Mount Morris, MI; Flint, MI; Flushing, MI; Burton, MI…

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5900 Waldon Rd
Ste A
Clarkston, MI 48346
Phone (248) 625-7890

425 N Fenway Dr
Ste A
Fenton, MI 48430
Phone (810) 750-5444

1515 W Atherton Rd
Flint, MI 48507
Phone (810) 232-5189

1434 Flushing Rd
Flushing, MI 48433
Phone (810) 659-3196

8423 Holly Rd
Ste A
Grand Blanc, MI 48439
Phone (810) 579-0466

8447 Holly Rd
Ste A
Grand Blanc, MI 48439
Phone (810) 603-0856

9030 State Rd
Millington, MI 48746
Phone (517) 871-4501

4485 E Mount Morris Rd
Mount Morris, MI 48458
Phone (810) 640-1942

Practitioners & affiliated clinicians

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1535932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1003398470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 E MOUNT MORRIS RD",
            "city": "MOUNT MORRIS",
            "state": "MI",
            "postal_code": "484588963",
            "telephone_number": "810-424-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD MEDICAL GROUP GENESYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-03",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "CEBALT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-874-6764"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Morris, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.