NPIMap

Organization Active NPI

Wellstreet Urgent Care of Michigan

  • Non-Pharmacy Dispensing Site
  • Southgate, MI
National Provider Identifier
1265218895
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
WELLSTREET URGENT CARE OF MICHIGAN
Practice address
16525 Fort St
Southgate, MI 48195-1403
Phone
(734) 250-9529
NPI assigned
Sep 8, 2023
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Lee A ResnickNPI 1477659134
Title
Cgo
Phone
(216) 383-3480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

National Provider Directory

National Provider Directory
Tax ID family
Wellstreet Urgent Care of Michigan26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

NPPES NPI Registry

Primary practice location

16525 Fort St
Southgate, MI 48195-1403

Mailing address

1825 Highway 34 E
Newnan, GA 30265-6423

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address amansour@wellstreet.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 8, 2023.

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1265218895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 HIGHWAY 34 E",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16525 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951403",
            "telephone_number": "734-250-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTREET URGENT CARE OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "RESNICK",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CGO",
        "authorized_official_telephone_number": "216-383-3480"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amansour@wellstreet.com",
            "affiliation": "N",
            "address_1": "16525 Fort St",
            "city": "Southgate",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481951403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.