North Macomb Family Practice, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101013932 Issued in MI

Legal business name

NORTH MACOMB FAMILY PRACTICE, P.C.

Practice address

48762 Gratiot Ave
Chesterfield, MI 48051-2675

Phone

(586) 421-1075

Fax

(586) 421-1085

NPI assigned

Jan 11, 2006

Organization subpart

No

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

Authorized official

Name

Andrew D Adair, D.O.

Title

President

Phone

(586) 421-1075

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235118076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48762 GRATIOT AVE",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480512675",
            "telephone_number": "586-421-1075",
            "fax_number": "586-421-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48762 GRATIOT AVE",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480512675",
            "telephone_number": "586-421-1075",
            "fax_number": "586-421-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MACOMB FAMILY PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADAIR",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-421-1075",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD PIN",
            "identifier": "0855011334",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MICHIGAN P",
            "identifier": "24033",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4691294",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES ID NUMBER",
            "identifier": "148005",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kathleen Nowicki, LLMSW CTP-C
• Angela Nowosielski

• Family Medicine Physician in Chesterfield, MI
• Providers in Chesterfield, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.