Active NPI
Epic Primary Care III PLLC
- Family Medicine Physician
- Dearborn, MI
National Provider Identifier
1275920084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- EPIC PRIMARY CARE III PLLC
- Practice address
- 2040 Monroe St Ste 208
Dearborn, MI 48124-2950 - Phone
- (248) 336-4000
- Fax
- (248) 336-9137
- NPI assigned
- Apr 20, 2015
- Last updated
- Aug 7, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ted Naman, MD
- Title
- Member
- Phone
- (248) 336-4000
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Pediatrics Physician | 208000000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
2040 Monroe St Ste 208
Dearborn, MI 48124-2950
Mailing address
390 Enterprise CT
Suite 103
Bloomfield Hills, MI 48302-0320
Phone (248) 336-4000
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Ferndale, MI
- NPI 1730156050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429488000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1438905600000",
"number": "1275920084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 ENTERPRISE CT",
"address_2": "SUITE 103",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483020320",
"telephone_number": "248-336-4000",
"fax_number": "248-336-9137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 MONROE ST STE 208",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242950",
"telephone_number": "248-336-4000",
"fax_number": "248-336-9137"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EPIC PRIMARY CARE III PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-04-20",
"last_updated": "2015-08-07",
"status": "A",
"authorized_official_last_name": "NAMAN",
"authorized_official_first_name": "TED",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "248-336-4000",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.