Filemon Jose Inocencio, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

4301041260 Issued in MI

Practice address

4047 Lake Chapin Rd
Berrien Springs, MI 49103-9654

Phone

(269) 815-3052

Fax

(269) 815-3052

NPI assigned

Feb 28, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1235779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235779200000",
    "number": "1194965335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 LAKE CHAPIN RD",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039654",
            "telephone_number": "269-815-3052",
            "fax_number": "269-815-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 LAKE CHAPIN RD",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039654",
            "telephone_number": "269-815-3052",
            "fax_number": "269-815-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INOCENCIO",
        "first_name": "FILEMON",
        "middle_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-28",
        "last_updated": "2009-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MI",
            "license": "4301041260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Berrien Springs, MI
• Providers in Berrien Springs, MI by specialty
• Adult Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2009; 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.