NPIMap

Organization Active NPI

Affiliated Medical of Dearborn P.L.L.C.

  • Diagnostic Radiology Physician
  • Dearborn, MI
National Provider Identifier
1235109786
Registry record updated Jul 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
AFFILIATED MEDICAL OF DEARBORN P.L.L.C.
Practice address
2200 Monroe St
Dearborn, MI 48124-3058
Phone
(313) 562-6607
Fax
(313) 562-5851
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2007

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

Authorized official

Name
Mrs. Mary A Kennedy, RT
Title
Office Manager
Phone
(313) 562-6607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2200 Monroe St
Dearborn, MI 48124-3058

Mailing address

2200 Monroe St
Dearborn, MI 48124-3058
Phone (313) 562-6607

National Provider Directory

National Provider Directory

Locations

2200 Monroe St
Dearborn, MI 48124
Phone (313) 274-0990

2200 Monroe St
Ste B
Dearborn, MI 48124
Phone (313) 562-0773

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185840000000",
    "number": "1235109786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243058",
            "telephone_number": "313-562-6607",
            "fax_number": "313-562-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243058",
            "telephone_number": "313-562-6607",
            "fax_number": "313-562-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED MEDICAL OF DEARBORN P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-07-31",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-562-6607",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RT"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; 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.