NPIMap

Organization Active NPI

Okemos Primary Care Physicians PC

  • Primary Care Clinic/Center
  • Okemos, MI
National Provider Identifier
1104079268
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
4301087786 Issued in MI
Legal business name
OKEMOS PRIMARY CARE PHYSICIANS PC
Practice address
2104 Jolly Rd
Suite 290
Okemos, MI 48864-6038
Phone
(517) 708-7283
Fax
(517) 708-7294
NPI assigned
Nov 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Authorized official

Name
Dr. Sudha R Yenumula, M.D.
Title
President and Ceo
Phone
(517) 708-7283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 4301087786 MI Primary

Addresses

Primary practice location

2104 Jolly Rd
Suite 290
Okemos, MI 48864-6038

Mailing address

2104 Jolly Rd
Suite 290
Okemos, MI 48864-6038
Phone (517) 708-7283

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1225584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1104079268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 JOLLY RD",
            "address_2": "SUITE 290",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646038",
            "telephone_number": "517-708-7283",
            "fax_number": "517-708-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 JOLLY RD",
            "address_2": "SUITE 290",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646038",
            "telephone_number": "517-708-7283",
            "fax_number": "517-708-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKEMOS PRIMARY CARE PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-02",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "YENUMULA",
        "authorized_official_first_name": "SUDHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "517-708-7283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301087786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.