NPIMap

Organization Active NPI

Prosperity Medical Clinical Group

  • Family Medicine Physician
  • Plymouth, MI
National Provider Identifier
1164359451
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PROSPERITY MEDICAL CLINICAL GROUP
Practice address
186 N Main St FL 2
Plymouth, MI 48170-1236
Phone
(989) 331-0933
NPI assigned
May 8, 2026
Organization subpart
Yes
Parent organization
PROSPERITY MEDICAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Tiffany Yang
Title
Secretary
Phone
(989) 331-0933

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

186 N Main St FL 2
Plymouth, MI 48170-1236

Mailing address

107 Greenwich St FL 14
New York, NY 10006-1898
Phone (989) 331-0933

National Provider Directory

National Provider Directory
Tax ID family
Prosperity Medical LLC2 organizations share this tax ID, including this one
Part of
Prosperity Medical LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1778198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1164359451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 GREENWICH ST FL 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061898",
            "telephone_number": "989-331-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 N MAIN ST FL 2",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701236",
            "telephone_number": "989-331-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY MEDICAL CLINICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROSPERITY MEDICAL, LLC",
        "enumeration_date": "2026-05-08",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "989-331-0933"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.