NPIMap

Organization Active NPI

Prime Garden City Medical Group

  • Obstetrics & Gynecology Physician
  • Dearborn Heights, MI
National Provider Identifier
1104163013
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PRIME GARDEN CITY MEDICAL GROUP
Practice address
6221 N Telegraph Rd
Dearborn Heights, MI 48127-3222
Phone
(313) 561-2200
Fax
(313) 561-2211
NPI assigned
Jan 11, 2013
Organization subpart
Yes
Parent organization
PRIME GARDEN CITY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Authorized official

Name
Mr. John F Magnuson
Title
Practice Administrator
Phone
(734) 458-4490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

6221 N Telegraph Rd
Dearborn Heights, MI 48127-3222

Mailing address

6221 N Telegraph Rd
Dearborn Heights, MI 48127-3222
Phone (313) 561-2200

Other names 1

  • Center for Women's Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prime Garden Med Group9 organizations share this tax ID, including this one
Part of
Prime Garden Med Group

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1104163013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 N TELEGRAPH RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273222",
            "telephone_number": "313-561-2200",
            "fax_number": "313-561-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 N TELEGRAPH RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273222",
            "telephone_number": "313-561-2200",
            "fax_number": "313-561-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME GARDEN CITY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME GARDEN CITY MEDICAL GROUP",
        "enumeration_date": "2013-01-11",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "MAGNUSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "734-458-4490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.