NPIMap

Organization Active NPI

Michigan Adult & Child Medicine

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1174693097
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MICHIGAN ADULT & CHILD MEDICINE
Practice address
8545 Common Road
Suite 200
Warren, MI 48093
Phone
(586) 751-0732
Fax
(586) 751-3822
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Authorized official

Name
Mrs. Marta Louise Belbot
Title
Office Manager
Phone
(586) 751-0732

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X

Addresses

Primary practice location

8545 Common Road
Suite 200
Warren, MI 48093

Mailing address

8545 Common Road
Suite 200
Warren, MI 48093
Phone (586) 751-0732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070223000040 MI Part B Supplier - Clinic/Group Practice 9638271505 Receives reassigned benefits from 6 practitioners
Practice locations: Warren, MI

National Provider Directory

National Provider Directory

Locations

8545 Common Rd
Ste 200
Warren, MI 48093
Phone (586) 751-0732

Practitioners & affiliated clinicians

Practitioners 8

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1174693097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8545 COMMON ROAD",
            "address_2": "SUITE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-751-0732",
            "fax_number": "586-751-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8545 COMMON ROAD",
            "address_2": "SUITE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-751-0732",
            "fax_number": "586-751-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN ADULT & CHILD MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "BELBOT",
        "authorized_official_first_name": "MARTA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-751-0732",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.