NPIMap

Organization Active NPI

Clio Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Clio, MI
National Provider Identifier
1114340171
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CLIO URGENT CARE PLLC
Practice address
4272 W Vienna Rd
Clio, MI 48420-9454
Phone
(810) 919-9416
Fax
(810) 686-1687
NPI assigned
Jan 28, 2014
Last updated
Nov 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Authorized official

Name
Nusrat Javaid, M.DNPI 1063501591
Title
Medical Director
Phone
(810) 919-9415

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
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

4272 W Vienna Rd
Clio, MI 48420-9454

Mailing address

4272 W Vienna Rd
Clio, MI 48420
Phone (810) 919-9415

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150302001179 MI Part B Supplier - Clinic/Group Practice 2062738446 Receives reassigned benefits from 16 practitioners
Practice locations: Clio, MI

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2076668Clio Urgent Care4272 W Vienna Road, Clio, MI 48420Certificate of waiverApr 23, 2028

National Provider Directory

National Provider Directory

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": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1114340171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4272 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "48420",
            "telephone_number": "810-919-9415",
            "fax_number": "810-686-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4272 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484209454",
            "telephone_number": "810-919-9416",
            "fax_number": "810-686-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIO URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "JAVAID",
        "authorized_official_first_name": "NUSRAT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "810-919-9415",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clio, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.