NPIMap

Organization Active NPI

Family Wellness Practice PLLC

  • Pain Clinic/Center
  • Eastpointe, MI
National Provider Identifier
1235497884
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
FAMILY WELLNESS PRACTICE PLLC
Practice address
21261 Kelly Rd
Eastpointe, MI 48021-3125
Phone
(586) 944-0085
NPI assigned
May 1, 2012
Last updated
Oct 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Mr. Bernard Foster
Title
Owner
Phone
(248) 469-3646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

21261 Kelly Rd
Eastpointe, MI 48021-3125

Mailing address

21261 Kelly Rd
Eastpointe, MI 48021-3125
Phone (586) 944-0085

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1235497884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21261 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213125",
            "telephone_number": "586-944-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21261 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213125",
            "telephone_number": "586-944-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WELLNESS PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-469-3646",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.