NPIMap

Organization Active NPI

Genesys Pho LLC

  • Case Management Agency
  • Burton, MI
National Provider Identifier
1275820110
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
GENESYS PHO LLC
Practice address
3495 S Center Rd
Burton, MI 48519-1455
Phone
(810) 424-2201
Fax
(810) 743-1099
NPI assigned
Jun 29, 2011
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Ann Donnelly, RN, BSN, MA
Title
President
Phone
(810) 424-2201

Practitioners 66

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

View all 66

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180419001744 MI Part B Supplier - Clinic/Group Practice 7618240409 Receives reassigned benefits from 66 practitioners
Practice locations: Burton, MI

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X MI Primary

Addresses

NPPES NPI Registry

Primary practice location

3495 S Center Rd
Burton, MI 48519-1455

Mailing address

3495 S Center Rd
Burton, MI 48519-1455

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 1, 2025.

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1275820110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455",
            "telephone_number": "810-424-2201",
            "fax_number": "810-743-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESYS PHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-29",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-424-2201",
        "authorized_official_credential": "RN, BSN, MA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.