NPIMap

Organization Active NPI

Kairos Healthcare Incorporated

  • Social Worker
  • Bridgeport, MI
National Provider Identifier
1184758435
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
KAIROS HEALTHCARE INCORPORATED
Practice address
6379 Dixie Hwy
Bridgeport, MI 48722-9566
Phone
(989) 777-4357
Fax
(989) 777-7257
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Authorized official

Name
Mr. Fred E. Wigen Jr.
Title
President Ceo
Phone
(989) 777-4357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

6379 Dixie Hwy
Bridgeport, MI 48722-9566

Mailing address

6379 Dixie Hwy
Bridgeport, MI 48722-9566
Phone (989) 777-4357

Other identifiers 3

IdentifierTypeStateIssuer
328565OtherMIVALUE OPTIONS
14072OtherMIM CARE
7509108430OtherMIBCBS OF MI

National Provider Directory

National Provider Directory
Tax ID family
Kairos Healthcare Incorporated5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1184758435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6379 DIXIE HWY",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229566",
            "telephone_number": "989-777-4357",
            "fax_number": "989-777-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6379 DIXIE HWY",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229566",
            "telephone_number": "989-777-4357",
            "fax_number": "989-777-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIROS HEALTHCARE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "WIGEN",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "989-777-4357",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "328565",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M CARE",
            "identifier": "14072",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "7509108430",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.