Organization Active NPI

Millennium Optimum Care, LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Jackson, MI
National Provider Identifier
1235462193
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
MILLENNIUM OPTIMUM CARE, LLC
Practice address
603 Lansing Avenue
Jackson, MI 49202-3209
Phone
(517) 787-8371
Fax
(517) 787-2639
NPI assigned
Sep 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Authorized official

Name
David O Bankole, MD
Title
President
Phone
(517) 787-8371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Primary

Addresses

Primary practice location

603 Lansing Avenue
Jackson, MI 49202-3209

Mailing address

603 Lansing Avenue
Jackson, MI 49202-3209
Phone (517) 787-8371

National Provider Directory

National Provider Directory

Locations

603 Lansing Ave
Jackson, MI 49202
Phone (517) 787-8371

NPI Registry JSON

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1235462193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 LANSING AVENUE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023209",
            "telephone_number": "517-787-8371",
            "fax_number": "517-787-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 LANSING AVENUE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023209",
            "telephone_number": "517-787-8371",
            "fax_number": "517-787-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM OPTIMUM CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-10",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "BANKOLE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-787-8371",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.