Athens Clinic, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OH26109 Issued in MI

Legal business name

ATHENS CLINIC, P.C.

Practice address

15100 S Plaza Dr
Taylor, MI 48180-5203

Phone

(734) 287-3700

Fax

(734) 287-1859

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Barbara Barr

Title

Office Manager

Phone

(734) 287-3700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124151881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15100 S PLAZA DR",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481805203",
            "telephone_number": "734-287-3700",
            "fax_number": "734-287-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15100 S PLAZA DR",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481805203",
            "telephone_number": "734-287-3700",
            "fax_number": "734-287-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARR",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "734-287-3700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "OH26109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1128511",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ellen K Athens, D.O.
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• Omar Attalla, PHARMD

• All providers in Taylor, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.