NPIMap

Organization Active NPI

Associated General Practice Network PLLC

  • Clinic/Center
  • Detroit, MI
National Provider Identifier
1144496860
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ASSOCIATED GENERAL PRACTICE NETWORK PLLC
Practice address
11803 Grand River Ave
Detroit, MI 48204-1810
Phone
(313) 491-5544
Fax
(248) 485-6631
NPI assigned
May 2, 2008
Last updated
Oct 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Ms. Indira Desikachar
Title
Member
Phone
(248) 231-8542

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

11803 Grand River Ave
Detroit, MI 48204-1810

Mailing address

30345 Rushmore Cir
Franklin, MI 48025-1510
Phone (248) 231-8542

Other identifiers 1

IdentifierTypeStateIssuer
11-0-H2-3914-0OtherMIBCBS

National Provider Directory

National Provider Directory

Locations

11803 Grand River Ave
Detroit, MI 48204
Phone (248) 231-8542

Practitioners & affiliated clinicians

Practitioners 7

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": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1144496860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30345 RUSHMORE CIR",
            "city": "FRANKLIN",
            "state": "MI",
            "postal_code": "480251510",
            "telephone_number": "248-231-8542",
            "fax_number": "248-485-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482041810",
            "telephone_number": "313-491-5544",
            "fax_number": "248-485-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED GENERAL PRACTICE NETWORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "DESIKACHAR",
        "authorized_official_first_name": "INDIRA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "248-231-8542",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11-0-H2-3914-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.