NPIMap

Organization Active NPI

East Michigan Family Care PLC

Doing business as East Michigan Family Care

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1124135116
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013727 Issued in MI
Legal business name
EAST MICHIGAN FAMILY CARE PLC
Doing business as
East Michigan Family Care
Practice address
4415 N Grand River Ave
Lansing, MI 48906-2614
Phone
(517) 323-3646
Fax
(517) 323-3648
NPI assigned
Aug 24, 2006
Last updated
Apr 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Shannon G Wiggins, D.O.NPI 1295744530
Title
Owner
Phone
(517) 323-3646

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 5101013727 MI Primary

Addresses

Primary practice location

4415 N Grand River Ave
Lansing, MI 48906-2614

Mailing address

2310 E Michigan Ave
Lansing, MI 48912-4018
Phone (517) 346-7628

Other identifiers 5

IdentifierTypeStateIssuer
0853310215OtherMIBCN
5101013727OtherMIDR WIGGINS LICENSE #
4924592MedicaidMI
0853310215OtherMIBCBS
1295744530OtherMIDR WIGGINS NPI#

Other names 1

  • EAST MICHIGAN FAMILY CARE Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1124135116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124018",
            "telephone_number": "517-346-7628",
            "fax_number": "517-346-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 N GRAND RIVER AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489062614",
            "telephone_number": "517-323-3646",
            "fax_number": "517-323-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST MICHIGAN FAMILY CARE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-323-3646",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "0853310215",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR WIGGINS LICENSE #",
            "identifier": "5101013727",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4924592",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0853310215",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR WIGGINS NPI#",
            "identifier": "1295744530",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST MICHIGAN FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.