NPIMap

Organization Active NPI

City of Detroit

Doing business as Detroit Health Department

  • Public Health or Welfare Agency
  • Detroit, MI
National Provider Identifier
1033429394
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CITY OF DETROIT
Doing business as
Detroit Health Department
Practice address
100 Mack Ave FL 1
Detroit, MI 48201-2416
Phone
(313) 480-3831
Fax
(313) 877-9305
NPI assigned
Oct 20, 2010
Last updated
Apr 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Brandon Atkins
Title
Director of Clinical Administration
Phone
(313) 348-2883

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary
Public Health & General Preventive Medicine Physician 2083P0901X NU

Addresses

Primary practice location

100 Mack Ave FL 1
Detroit, MI 48201-2416

Mailing address

100 Mack Ave FL 3
Detroit, MI 48201-2416
Phone (313) 876-0349

Other identifiers 1

IdentifierTypeStateIssuer
4456991MedicaidMI

Other names 2

  • Detroit Health Department Doing business as
  • City of Detroit Wellness Health Promo Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041022001114 MI Part B Supplier - Clinic/Group Practice 1456312388 Receives reassigned benefits from 2 practitioners
Practice locations: Detroit, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2126301Detroit Health Department100 Mack Avenue, Detroit, MI 48201Certificate of waiverFeb 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
City of Detroit Fire de15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations (25 of 35)

100 Mack Ave
Fl 1
Detroit, MI 48201
Phone (313) 480-3831

100 Mack Ave
Fl 3
Detroit, MI 48201

10200 Erwin St
Detroit, MI 48234
Phone (313) 237-3111

10700 Shoemaker St
Detroit, MI 48213
Phone (313) 286-4056

10801 Whittier St
Detroit, MI 48224
Phone (313) 283-9471

111 Kenilworth St
Detroit, MI 48202
Phone (313) 205-9738

1151 Taylor St
Rm 150C
Detroit, MI 48202
Phone (313) 876-4220

1151 Taylor St
Rm 340C
Detroit, MI 48202

11740 E Jefferson Ave
Detroit, MI 48214
Phone (313) 282-8825

12985 Houston Whittier St
Detroit, MI 48205
Phone (313) 283-6099

1301 3rd St
Ste 607
Detroit, MI 48226
Phone (313) 596-5188

13939 Dexter Ave
Detroit, MI 48238
Phone (313) 287-5176

1400 Erskine St
Detroit, MI 48207
Phone (313) 237-3165

14585 Greenfield Rd
Detroit, MI 48227
Phone (313) 852-4435

15127 Greenfield Rd
Detroit, MI 48227
Phone (313) 283-2018

16543 Meyers Rd
Detroit, MI 48235
Phone (313) 207-8291

16825 Trinity St
Detroit, MI 48219
Phone (313) 333-0531

1697 W Grand Blvd
Detroit, MI 48208
Phone (313) 596-5427

17800 Curtis St
Detroit, MI 48235
Phone (313) 207-1798

18140 Joy Rd
Detroit, MI 48228
Phone (313) 286-4352

18236 Livernois Ave
Detroit, MI 48221
Phone (313) 333-6242

18601 Ryan Rd
Detroit, MI 48234
Phone (313) 283-5017

2200 Crane St
Detroit, MI 48214
Phone (313) 283-0029

2300 S Fort St
Detroit, MI 48217
Phone (313) 286-6144

250 W Larned St
Fl Second
Detroit, MI 48226
Phone (313) 596-5188

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1033429394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MACK AVE FL 3",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012416",
            "telephone_number": "313-876-0349",
            "fax_number": "313-877-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MACK AVE FL 1",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012416",
            "telephone_number": "313-480-3831",
            "fax_number": "313-877-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF DETROIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "ATKINS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL ADMINISTRATION",
        "authorized_official_telephone_number": "313-348-2883"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4456991",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Detroit Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "City of Detroit Wellness Health Promo",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.