Canton Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CANTON MEDICAL CLINIC

Practice address

37662 Ford Rd
Westland, MI 48185-1924

Phone

(734) 238-3800

Fax

(734) 238-3803

NPI assigned

Jan 29, 2020

Last updated

Feb 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nida Latif, MDNPI 1235144759

Title

Owner

Phone

(269) 548-9602

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Nida Latif, MD

  • Family Medicine Physician
  • Westland, MI
  • NPI 1235144759
  Medicare reassignment NPD Authorized official
• Haseeb A Khawaja, MD

  • Internal Medicine Physician
  • Warren, MI
  • NPI 1679580104
  Medicare reassignment NPD

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1053942060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37662 FORD RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481851924",
            "telephone_number": "734-238-3800",
            "fax_number": "734-238-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37662 FORD RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481851924",
            "telephone_number": "734-238-3800",
            "fax_number": "734-238-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "LATIF",
        "authorized_official_first_name": "NIDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-548-9602",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235144759",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "practicefusion.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cantonmedicalclinic.org",
            "address_1": "37662 Ford Rd",
            "city": "Westland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481851924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deshaunt'E Aaron Burns
• Tracy Butsky
• Jerry Keith Buxmann, DC
• Camelot Hall Acquisition Company Inc (Camelot Hall Convalescent Center)
• Michael Dale Cameron, D.C.
• Charles M Canvasser, RPH
• Gina Bertinette Capalbo, D.O.
• Louise Lynn Capraro, M.A., LLP
• Care Givers, Inc.
• Care Source Inc

• Family Medicine Physician in Westland, MI
• Providers in Westland, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.