NPIMap

Organization Active NPI

Cecelia F. Hissong, M. D., P. C.

  • Family Medicine Physician
  • Dearborn, MI
National Provider Identifier
1033295167
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
CH027214 Issued in MI
Legal business name
CECELIA F. HISSONG, M. D., P. C.
Practice address
23100 Cherry Hill Rd.
Dearborn, MI 48124-1493
Phone
(313) 563-5310
Fax
(313) 563-8147
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Authorized official

Name
Cecelia F. Hissong, M. D.NPI 1780685008
Title
President
Phone
(313) 563-5310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X CH027214 MI Primary

Addresses

Primary practice location

23100 Cherry Hill Rd.
Dearborn, MI 48124-1493

Mailing address

23100 Cherry Hill Rd.
Dearborn, MI 48124-1493
Phone (313) 563-5310

Other identifiers 6

IdentifierTypeStateIssuer
B44598OtherMIHAP ID
0824144OtherMIBLUE CARE NETWORK ID
C3390OtherMIM-CARE ID
10/2095139MedicaidMI
126367OtherMICARE CHOICES
080824144OtherMIBLUE CROSS BLUE SHIELD ID

National Provider Directory

National Provider Directory
Tax ID family
Cecelia F Hissong M D P C2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

23100 Cherry Hill St
Dearborn, MI 48124
Phone (313) 278-5444

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292976000000",
    "number": "1033295167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23100 CHERRY HILL RD.",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241493",
            "telephone_number": "313-563-5310",
            "fax_number": "313-563-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 CHERRY HILL RD.",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241493",
            "telephone_number": "313-563-5310",
            "fax_number": "313-563-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CECELIA F. HISSONG, M. D., P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2010-12-22",
        "status": "A",
        "authorized_official_last_name": "HISSONG",
        "authorized_official_first_name": "CECELIA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-563-5310",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "CH027214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP ID",
            "identifier": "B44598",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK ID",
            "identifier": "0824144",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE ID",
            "identifier": "C3390",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10/2095139",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "126367",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "080824144",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.