Individual provider Active NPI

Nicholas Sean Packey, D.O.

  • Family Medicine Physician
  • Garden City, MI
National Provider Identifier
1104130558
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101018950 Issued in MI
Practice address
30730 Ford Rd
Garden City, MI 48135-1803
Phone
(734) 421-7474
Fax
(734) 421-0961
NPI assigned
Jul 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101018950 MI Primary

Addresses

Primary practice location

30730 Ford Rd
Garden City, MI 48135-1803

Mailing address

30730 Ford Rd
Garden City, MI 48135-1803
Phone (734) 421-7474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131021001703 MI Practitioner - Family Practice 7618102070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, 349 clinicians

Practice addresses (Care Compare)

15717 15 Mile Rd
Clinton Township, MI 48035-2101
Phone (586) 285-3800

Hospital & facility affiliations

  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101018950MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Mar 1, 2016 Accepting new patients
Henry Ford Macomb Hospital Corporation Family Medicine CurrentSince Mar 1, 2016 Accepting new patients

Locations

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

Interoperability endpoints

  • Direct secure messaging: npackey394094@direct.hfhs.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376611200000",
    "number": "1104130558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30730 FORD RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351803",
            "telephone_number": "734-421-7474",
            "fax_number": "734-421-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30730 FORD RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351803",
            "telephone_number": "734-421-7474",
            "fax_number": "734-421-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKEY",
        "first_name": "NICHOLAS",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2013-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101018950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

Verify at the official NPI Registry.