J C Clinic

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301079383 Issued in MI

Legal business name

J C CLINIC

Practice address

2035 Hogback Rd
Suite 209
Ann Arbor, MI 48105-9732

Phone

(734) 794-0112

Fax

(734) 794-0112

NPI assigned

Apr 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jun Cao, M.D.

Title

President

Phone

(734) 794-0112

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265498125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 HOGBACK RD",
            "address_2": "SUITE 209",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059732",
            "telephone_number": "734-794-0112",
            "fax_number": "734-794-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 HOGBACK RD",
            "address_2": "SUITE 209",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059732",
            "telephone_number": "734-794-0112",
            "fax_number": "734-794-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J C CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAO",
        "authorized_official_first_name": "JUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-794-0112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301079383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4505719",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP HMO",
            "identifier": "H79731",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "136855",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore John Iwashyna, MD
• Sisanmofe Osamuede Iyamu, PHARMD
• Jennifer J. Iyengar, MD
• Matthew Iyer, MD, PHD
• Ramaswamy Krishna Iyer, PH.D.
• J Silva Goncalves Ed D Inc
• J. Richard Goulet,M.D., P.C.
• J.a. Consultants, LLC
• Merle J Jaarda, DDS MS
• Evelina Jabaay

• Psychiatry Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Psychiatry 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.