John R Medical Clinic, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

JOHN R MEDICAL CLINIC, PC

Practice address

26505 John R Rd
Madison Heights, MI 48071-3611

Phone

(248) 547-3100

Fax

(248) 547-4733

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

James M Kohlenberg, M.D.

Title

Owner

Phone

(248) 547-3100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Habib G Gennaoui, MD

  • Internal Medicine Physician
  • Madison Heights, MI
  • NPI 1437140225
  Medicare reassignment NPD
• Lakeisha Sutton

  • Community Health Worker
  • Madison Heights, MI
  • NPI 1851221931
  NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1225108343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26505 JOHN R RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713611",
            "telephone_number": "248-547-3100",
            "fax_number": "248-547-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26505 JOHN R RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713611",
            "telephone_number": "248-547-3100",
            "fax_number": "248-547-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R MEDICAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "KOHLENBERG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-547-3100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay First Enterprise P.L.L.C.
• Kelly Jewell
• Shanithia Jhons
• Joel J. Harris, D. O. P. C.
• John R Express Pharmacy PC
• Brittney E Johnson
• Christina M Johnson, BSPH, CBD-CPD, IBCLC
• Emily Michelle Johnson, D.O.
• Glenda Evon Johnson, LPN
• Kayla Jones

• Primary Care Clinic/Center in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.