NPIMap

Organization Active NPI

Wayne County Patient Care Management System

  • Public Health or Welfare Agency
  • Detroit, MI
National Provider Identifier
1285871954
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
4527725 Issued in MI
Legal business name
WAYNE COUNTY PATIENT CARE MANAGEMENT SYSTEM
Practice address
640 Temple St
Suite 370
Detroit, MI 48201-2599
Phone
(313) 833-3430
NPI assigned
Jan 16, 2009
Last updated
Jan 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Mr. Michael D. Grundy
Title
Director
Phone
(313) 833-3430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 4527725 MI Primary

Addresses

Primary practice location

640 Temple St
Suite 370
Detroit, MI 48201-2599

Mailing address

640 Temple St
Suite 370
Detroit, MI 48201-2599
Phone (313) 833-3430

Other identifiers 1

IdentifierTypeStateIssuer
4527725MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
St John Hospital11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

640 Temple St
Rm 370
Detroit, MI 48201
Phone (313) 833-3430

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1285871954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 TEMPLE ST",
            "address_2": "SUITE 370",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012599",
            "telephone_number": "313-833-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 TEMPLE ST",
            "address_2": "SUITE 370",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012599",
            "telephone_number": "313-833-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE COUNTY PATIENT CARE MANAGEMENT SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "GRUNDY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-833-3430",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MI",
            "license": "4527725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4527725",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.