PHS of Michigan PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4301094288 Issued in MI

Legal business name

PHS OF MICHIGAN PC

Practice address

1780 E Parnall Rd
Parnall Correction Facility- Medical Clinic
Jackson, MI 49201-7136

Phone

(517) 780-6393

NPI assigned

Jul 3, 2011

Organization subpart

No

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

Authorized official

Name

Erin Cody, MD

Title

State Medical Director

Phone

(517) 827-3200

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Sajjad Hussain, MD

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1174810741
  NPD (past)

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

{
    "created_epoch": "1309651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309651200000",
    "number": "1265729883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6452 MILLENNIUM STE 100",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489177881",
            "telephone_number": "800-207-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 E PARNALL RD",
            "address_2": "PARNALL CORRECTION FACILITY- MEDICAL CLINIC",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492017136",
            "telephone_number": "517-780-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHS OF MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-03",
        "last_updated": "2011-07-03",
        "status": "A",
        "authorized_official_last_name": "CODY",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "STATE MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "517-827-3200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4301094288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Pfiester, CF-SLP
• Pharaoh'S Rest Haven, L.L.C
• Ashley Phelps, LPC
• Brittany Latrice Phillips
• Drew Phillips
• Vivien Phung, MD
• Raven Picciotti
• Bruce Pickell
• Taryn Sue Pickell
• Daniel Karl Piekarek, NPC

• Clinic/Center in Jackson, MI
• Providers in Jackson, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2011; 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.