Organization Active NPI

Physician Management Services of Michigan, LLC

  • Family Medicine Physician
  • Midland, MI
National Provider Identifier
1255996591
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHYSICIAN MANAGEMENT SERVICES OF MICHIGAN, LLC
Practice address
920 W Wackerly St
Midland, MI 48640-2700
Phone
(888) 829-8550
NPI assigned
May 2, 2019
Organization subpart
Yes
Parent organization
VAXCARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Brett Kenefick
Title
President
Phone
(888) 829-8550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

920 W Wackerly St
Midland, MI 48640-2700

Mailing address

800 N Magnolia Ave Ste 700
Orlando, FL 32803-3264
Phone (888) 829-8550

Other practice location 1

2480 Rosewood N
MT Pleasant, MI 48858-5003
Phone (888) 829-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190814000974 TX Part B Supplier - Centralized Flu Biller 5092042077 Practice locations: Midland, MI

National Provider Directory

National Provider Directory
Part of
Vaxcare Corporation

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

920 W Wackerly St
Midland, MI 48640
Phone (517) 839-9937

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1255996591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MAGNOLIA AVE STE 700",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033264",
            "telephone_number": "888-829-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402700",
            "telephone_number": "888-829-8550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2480 Rosewood N",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "MI",
            "postal_code": "488585003",
            "country_code": "US",
            "telephone_number": "888-829-8550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIAN MANAGEMENT SERVICES OF MICHIGAN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAXCARE CORPORATION",
        "enumeration_date": "2019-05-02",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "KENEFICK",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-829-8550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.