NPIMap

Organization Active NPI

Henry Ford Health System

  • Clinic/Center
  • Wyandotte, MI
National Provider Identifier
1366832511
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
43010335400 Issued in MI
Legal business name
HENRY FORD HEALTH SYSTEM
Practice address
2333 Biddle Avenue
Henry Ford Wyandotte Hospital
Wyandotte, MI 48192
Phone
(734) 246-6036
NPI assigned
Jan 27, 2015
Last updated
Jan 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Authorized official

Name
Dr. Larry Leise Pack, MD
Title
Orthopaedic Surgeon
Phone
(810) 348-7907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 43010335400 MI Primary

Addresses

Primary practice location

2333 Biddle Avenue
Henry Ford Wyandotte Hospital
Wyandotte, MI 48192

Mailing address

2333 Biddle Ave.
Henry Ford Wyandotte Hospital
Wyandotte, MI 48192-9552
Phone (734) 246-6036

National Provider Directory

National Provider Directory
Tax ID family
Henry Ford Health System3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1366832511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE.",
            "address_2": "HENRY FORD WYANDOTTE HOSPITAL",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481929552",
            "telephone_number": "734-246-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVENUE",
            "address_2": "HENRY FORD WYANDOTTE HOSPITAL",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "48192",
            "telephone_number": "734-246-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "LEISE",
        "authorized_official_title_or_position": "ORTHOPAEDIC SURGEON",
        "authorized_official_telephone_number": "810-348-7907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "43010335400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; 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.