Community Care Associates

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

COMMUNITY CARE ASSOCIATES

Practice address

300 River Place Dr
Suite 2500
Detroit, MI 48207-4457

Phone

(313) 999-7603

Fax

(313) 656-6008

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Prof. Kathleen D Pelak-Reggio

Title

President

Phone

(313) 999-7603

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023169703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RIVER PLACE DR",
            "address_2": "SUITE 2500",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074457",
            "telephone_number": "313-999-7603",
            "fax_number": "313-656-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RIVER PLACE DR",
            "address_2": "SUITE 2500",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074457",
            "telephone_number": "313-999-7603",
            "fax_number": "313-656-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PELAK-REGGIO",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-999-7603",
        "authorized_official_name_prefix": "Prof."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Detroit, MI
• Providers in Detroit, MI by specialty
• Exclusive Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.