Adult Internal Medicine and Family Care, PLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ADULT INTERNAL MEDICINE AND FAMILY CARE, PLC

Practice address

134 S Cochran Ave
Charlotte, MI 48813-1557

Phone

(517) 541-1000

Fax

(517) 541-1754

NPI assigned

Jun 8, 2009

Last updated

Aug 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jack Cribb, DONPI 1497961635

Title

Owner

Phone

(517) 541-1000

Specialties & licenses 1

Addresses

Other identifiers 1

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

Practitioners 1

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.

• Jack Edison Cribb, D.O.

  • Internal Medicine Physician
  • Charlotte, MI
  • NPI 1497961635
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250467200000",
    "number": "1174759989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488130367",
            "telephone_number": "517-485-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 S COCHRAN AVE",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131557",
            "telephone_number": "517-541-1000",
            "fax_number": "517-541-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT INTERNAL MEDICINE AND FAMILY CARE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-08-17",
        "status": "A",
        "authorized_official_last_name": "CRIBB",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-541-1000",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0B30018",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Charlotte, MI
• Providers in Charlotte, 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 Aug 17, 2009; 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.