NPIMap

Organization Active NPI

Encore Geriatrics PLLC

  • General Practice Physician
  • Westland, MI
National Provider Identifier
1053811380
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5101007865 Issued in MI
Legal business name
ENCORE GERIATRICS PLLC
Practice address
8365 N Newburgh Rd
Westland, MI 48185-1149
Phone
(423) 310-1642
NPI assigned
Feb 13, 2018
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Andrew Colman, DONPI 1912983131
Title
Owner
Phone
(423) 310-1642

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
General Practice Physician 208D00000X 5101007865 MI Primary

Addresses

Primary practice location

8365 N Newburgh Rd
Westland, MI 48185-1149

Mailing address

PO Box 2444
Dalton, GA 30722-2444
Phone (423) 310-1642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180328001184 MI Part B Supplier - Clinic/Group Practice 6507128774 Receives reassigned benefits from 14 practitioners

National Provider Directory

National Provider Directory

Locations

1014 Center Ave
Bay City, MI 48708
Phone (989) 892-8493

3740 2 Mile Rd
Bay City, MI 48706
Phone (989) 439-9333

200 N Canton Center Rd
Canton, MI 48187
Phone (734) 656-8883

255 N Main St
Freeland, MI 48623
Phone (989) 651-5100

1948 Cooper St
Jackson, MI 49202
Phone (517) 782-1900

34020 Plymouth Rd
Livonia, MI 48150
Phone (248) 233-6443

520 Main St
#M
Manistique, MI 49854
Phone (906) 341-6921

4124 Waldo Ave
Midland, MI 48642
Phone (989) 423-0742

4617 Eastman Ave
Midland, MI 48640
Phone (989) 495-2427

5275 Mackinaw Rd
Saginaw, MI 48603
Phone (989) 209-1700

5475 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 781-2380

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1053811380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2444",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307222444",
            "telephone_number": "423-310-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8365 N NEWBURGH RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481851149",
            "telephone_number": "423-310-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCORE GERIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-13",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "COLMAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-310-1642",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101007865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.