Active NPI
Wellness Center of Michigan LLC
- Specialist
- Southfield, MI
National Provider Identifier
1295039899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 4301041657
- Legal business name
- WELLNESS CENTER OF MICHIGAN LLC
- Practice address
- 17336 W 12 Mile Rd Ste 102
Southfield, MI 48076-2113 - Phone
- (248) 943-8860
- NPI assigned
- Dec 23, 2010
- 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
- Dimple Tripathi
- Title
- Ceo
- Phone
- (248) 943-8860
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4301041657 | MI | Primary |
Addresses
Primary practice location
17336 W 12 Mile Rd Ste 102
Southfield, MI 48076-2113
Mailing address
17336 W 12 Mile Rd Ste 102
Southfield, MI 48076-2113
Phone (248) 943-8860
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293062400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1293062400000",
"number": "1295039899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17336 W 12 MILE RD STE 102",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762113",
"telephone_number": "248-943-8860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17336 W 12 MILE RD STE 102",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762113",
"telephone_number": "248-943-8860"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLNESS CENTER OF MICHIGAN LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-12-23",
"last_updated": "2010-12-23",
"status": "A",
"authorized_official_last_name": "TRIPATHI",
"authorized_official_first_name": "DIMPLE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "248-943-8860"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": "MI",
"license": "4301041657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.