Center for Preventive Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CENTER FOR PREVENTIVE MEDICINE PC

Practice address

20870 Mack Ave
Grosse Pointe Woods, MI 48236-1388

Phone

(313) 885-2334

Fax

(313) 647-4837

NPI assigned

Sep 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephenie Lucas, MDNPI 1023116068

Title

Owner

Phone

(313) 885-2334

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Stephenie M Lucas, M.D.

  • General Practice Physician
  • Saint Clair Shores, MI
  • NPI 1023116068

  Internal Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Kulinski, FNP-BC

  • Family Nurse Practitioner
  • Saint Clair Shores, MI
  • NPI 1033595749
  Medicare reassignment Care Compare group NPD
• Ann Marie Frances Gabrielson, RN-NP

  • Adult Health Nurse Practitioner
  • Dearborn Heights, MI
  • NPI 1861825242
  Medicare reassignment NPD
• Vamshidhar Guduguntla, MD

  • Cardiovascular Disease Physician
  • Roseville, MI
  • NPI 1174525729
  Medicare reassignment NPD
• Logan A Oney, MD

  • Internal Medicine Physician
  • Saint Clair Shores, MI
  • NPI 1740397207
  Medicare reassignment NPD
• Carol Marie Malone, AGNP

  • Nurse Practitioner
  • Orlando, FL
  • NPI 1619219003
  NPD

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493856000000",
    "number": "1174719025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20870 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361388",
            "telephone_number": "313-885-2334",
            "fax_number": "313-647-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20870 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361388",
            "telephone_number": "313-885-2334",
            "fax_number": "313-647-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PREVENTIVE MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2017-05-04",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "STEPHENIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-885-2334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Carter
• Thomas Charles Catrett III
• Angelina Cavaliere
• Ccla 6 LLC
• Omolara Ceasar
• Ashley Abraham Chacko, DMD
• Maria-Liliana Chavez, BCBA
• Sapna Chhaya
• Childrens's Home of Detroit
• Michael Cholagh

• Internal Medicine Physician in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.