NPIMap

Organization Active NPI

Center for Family Health

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1144390675
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTER FOR FAMILY HEALTH
Practice address
300 W Washington Ave
Suite 060
Jackson, MI 49201-2180
Phone
(517) 787-5970
Fax
(517) 787-3353
NPI assigned
Nov 9, 2006
Last updated
Sep 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

Authorized official

Name
Ms. Michelle Mayo
Title
Patient Account Supervisor
Phone
(517) 784-3950

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MI
Nurse Practitioner 363L00000X MI
Clinical Social Worker 1041C0700X MI
General Practice Dentistry 1223G0001X MI
Dental Hygienist 124Q00000X MI
Family Medicine Physician 207Q00000X MI Primary
Internal Medicine Physician 207R00000X MI

Addresses

Primary practice location

300 W Washington Ave
Suite 060
Jackson, MI 49201-2180

Mailing address

PO Box 548
Jackson, MI 49204-0548
Phone (517) 784-3950

Other identifiers 2

IdentifierTypeStateIssuer
500C807070OtherMIBCBSM GROUP PROVIDER
700C810070OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Center for Family Health Rose City Office Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040214000170 MI Part B Supplier - Clinic/Group Practice 4587574421 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, MI
O20040219000916 MI Part B Supplier - Clinic/Group Practice 4587574421 Receives reassigned benefits from 52 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, MI

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

300 W Washington Ave
Ste 60
Jackson, MI 49201
Phone (517) 783-4664

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1144390675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 548",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492040548",
            "telephone_number": "517-784-3950",
            "fax_number": "517-783-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE",
            "address_2": "SUITE 060",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012180",
            "telephone_number": "517-787-5970",
            "fax_number": "517-787-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PATIENT ACCOUNT SUPERVISOR",
        "authorized_official_telephone_number": "517-784-3950",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP PROVIDER",
            "identifier": "500C807070",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "700C810070",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Family Health Rose City Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.