Mobile Physician Group, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004300 Issued in MI

Legal business name

MOBILE PHYSICIAN GROUP, PLLC

Practice address

22137 Michigan Ave
Dearborn, MI 48124-2204

Phone

(734) 729-2300

NPI assigned

Jun 17, 2014

Organization subpart

No

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

Authorized official

Name

Ali H Fakih, D.O

Title

Owner

Phone

(734) 729-2300

Specialties & licenses 1

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lindsay Yeager Carr, PHD

  • Clinical Psychologist
  • Detroit, MI
  • NPI 1649511015
  NPD (past)
• Kai Mason, LLMSW

  • Clinical Social Worker
  • Detroit, MI
  • NPI 1255826095
  NPD (past)
• Jennifer A. Penney, OT

  • Occupational Therapist
  • Auburn Hills, MI
  • NPI 1164440467
  NPD (past)
• Morgan Peters, PTA

  • Physical Therapy Assistant
  • White Lake, MI
  • NPI 1417530668
  NPD (past)
• Andrew Patrick Tippen, SLP

  • Speech-Language Pathologist
  • White Lake, MI
  • NPI 1265122360
  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408665600000",
    "number": "1184038200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22137 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22137 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242204",
            "telephone_number": "734-729-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PHYSICIAN GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-08-22",
        "status": "A",
        "authorized_official_last_name": "FAKIH",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-729-2300",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Diane Mladic, DO
• MML Consulting Management LLC
• Wisam Nabeel Mnkana
• Mobicare
• Mobile Eye Care, LLC (Seen Vision Care)
• Melissa Daria Moccia-Patton, D.D.S.
• Romulo M Mocorro Jr., CRNA
• Modern American Dental Clinic P. C.
• Modern American Dental Clinic PC
• Modern Physical Therapy & Rehab, Inc.

• Optometrist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.