Integrated Geriatric Services PLLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

JW057004 Issued in MI

Legal business name

INTEGRATED GERIATRIC SERVICES PLLC

Practice address

3080 Fleming Lake Dr
Ann Arbor, MI 48105-8000

Phone

(734) 812-4219

Fax

(734) 327-6180

NPI assigned

Mar 17, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Wilborn Jr., M.D.

Title

Owner /Sole Member /Practitioner

Phone

(734) 812-4219

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1275774531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 JACKSON AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481033919",
            "telephone_number": "734-812-4219",
            "fax_number": "734-327-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 FLEMING LAKE DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481058000",
            "telephone_number": "734-812-4219",
            "fax_number": "734-327-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED GERIATRIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "WILBORN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "OWNER /SOLE MEMBER /PRACTITIONER",
        "authorized_official_telephone_number": "734-812-4219",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "JW057004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI TYPE 1",
            "identifier": "1750351516",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4637100-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.