Michele Pennington MD Family Medical PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301070192 Issued in MI

Legal business name

MICHELE PENNINGTON MD FAMILY MEDICAL PLLC

Practice address

25775 W 10 Mile Rd
Suite B
Southfield, MI 48034-4856

Phone

(248) 304-9400

Fax

(248) 304-9401

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michele Pennington, MD

Title

Owner/Physician

Phone

(248) 304-9400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyra Cherice McKinney, MD

  • Internal Medicine Physician
  • Cleveland, OH
  • NPI 1164413548

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1366484693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#6620 6620 RELIABLE PARKWAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "248-304-9400",
            "fax_number": "248-304-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25775 W 10 MILE RD",
            "address_2": "SUITE B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480344856",
            "telephone_number": "248-304-9400",
            "fax_number": "248-304-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELE PENNINGTON MD FAMILY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "PENNINGTON",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "248-304-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301070192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "0801975377",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBC BCN",
            "identifier": "0806346602",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Michael
• Hadeer Joseph Michael
• Robert S Michaels, M.D.
• Jefferey E Michaelson, MD
• Adrian Laith Michel, MD
• Michele Thomas, M.D., PLLC
• Collin Michele
• Michfoot Surgeons, P.C.
• Michigan Brain & Spine Physicians Group
• Michigan Care Management Solutions LLC

• All providers in Southfield, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.