NPIMap

Organization Active NPI

Farmbrook Internal Medicine Inc

  • Clinic/Center
  • Bingham Farms, MI
National Provider Identifier
1174772057
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
5101012230 Issued in MI
Legal business name
FARMBROOK INTERNAL MEDICINE INC
Practice address
31500 Telegraph Rd
Suite 130
Bingham Farms, MI 48025-4313
Phone
(248) 593-0575
Fax
(248) 433-3452
NPI assigned
Sep 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Authorized official

Name
Dr. Joseph N. Hagen, D.O.
Title
President
Phone
(248) 593-0575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 5101012230 MI Primary

Addresses

Primary practice location

31500 Telegraph Rd
Suite 130
Bingham Farms, MI 48025-4313

Mailing address

31500 Telegraph Rd
Suite 130
Bingham Farms, MI 48025-4313
Phone (248) 593-0575

Other identifiers 3

IdentifierTypeStateIssuer
199809MedicaidMI
G25356OtherMIBLUE CROSS UPIN
5631503OtherMIBCBSM PROVIDER CODE

National Provider Directory

National Provider Directory

Locations

31500 Telegraph Rd
Ste 150
Bingham Farms, MI 48025
Phone (248) 593-0575

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383264000000",
    "number": "1174772057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31500 TELEGRAPH RD",
            "address_2": "SUITE 130",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254313",
            "telephone_number": "248-593-0575",
            "fax_number": "248-433-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31500 TELEGRAPH RD",
            "address_2": "SUITE 130",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254313",
            "telephone_number": "248-593-0575",
            "fax_number": "248-433-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMBROOK INTERNAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2013-11-01",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-593-0575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "5101012230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199809",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS UPIN",
            "identifier": "G25356",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PROVIDER CODE",
            "identifier": "5631503",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.