My Urgent Medical Management Services

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MY URGENT MEDICAL MANAGEMENT SERVICES

Doing business as

Mobile MD

Practice address

21090 Allen Rd
Woodhaven, MI 48183-1602

Phone

(248) 820-9828

Fax

(734) 926-1911

NPI assigned

May 8, 2017

Organization subpart

No

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

Authorized official

Name

Shannon Ketelhut

Title

Executive Management

Phone

(248) 820-9828

Specialties & licenses 1

Addresses

Other names 1

• Mobile MD Doing business as

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

{
    "created_epoch": "1494201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1194251314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 S MAIN ST",
            "address_2": "SUITE 475",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036938",
            "telephone_number": "248-820-9828",
            "fax_number": "734-692-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21090 ALLEN RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831602",
            "telephone_number": "248-820-9828",
            "fax_number": "734-926-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY URGENT MEDICAL MANAGEMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-08",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "KETELHUT",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "EXECUTIVE MANAGEMENT",
        "authorized_official_telephone_number": "248-820-9828"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Woodhaven, MI
• Providers in Woodhaven, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.