NPIMap

Organization Active NPI

Serenity Physicians

  • Health Maintenance Organization
  • Dearborn, MI
National Provider Identifier
1295758159
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
4301028439 Issued in MI
Legal business name
SERENITY PHYSICIANS
Practice address
1009 Drexel St
Dearborn, MI 48128-1639
Phone
(313) 429-3164
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Rita D Rogers
Title
Manager
Phone
31342393164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 4301028439 MI Primary

Addresses

Primary practice location

1009 Drexel St
Dearborn, MI 48128-1639

Mailing address

1009 Drexel St
Dearborn, MI 48128-1639
Phone (313) 429-6164

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295758159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 DREXEL ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281639",
            "telephone_number": "313-429-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 DREXEL ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281639",
            "telephone_number": "313-429-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "31342393164",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MI",
            "license": "4301028439",
            "primary": true
        }
    ],
    "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 22, 2020; 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.