NPIMap

Organization Active NPI

Detroit Health Care for the Homeless

Doing business as Children Medical Center

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
National Provider Identifier
1346591336
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DETROIT HEALTH CARE FOR THE HOMELESS
Doing business as
Children Medical Center
Practice address
79 W Alexandrine St
Detroit, MI 48201-2015
Phone
(313) 833-2895
NPI assigned
Oct 1, 2012
Last updated
Oct 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Joseph W Ferguson
Title
Executive Director
Phone
(313) 416-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X MI Primary

Addresses

Primary practice location

79 W Alexandrine St
Detroit, MI 48201-2015

Mailing address

79 W Alexandrine St
Detroit, MI 48201-2015
Phone (313) 833-2895

Other names 1

  • Children Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526000397 MI Part B Supplier - Clinic/Group Practice 2668368572 Receives reassigned benefits from 14 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Detroit, MI; Warren, MI

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1346591336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-833-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-833-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT HEALTH CARE FOR THE HOMELESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-416-6200"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 1, 2012; 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.