Neurosurgery Group, P.C.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

028777 Issued in MI

Legal business name

NEUROSURGERY GROUP, P.C.

Doing business as

Wellness Physical Medicine Center

Practice address

43650 Garfield
Clinton TWP, MI 48038-6332

Phone

(586) 263-0820

Fax

(586) 263-3819

NPI assigned

Sep 28, 2006

Last updated

Aug 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Marie Theresa Chisholm

Title

Practice Manager

Phone

(586) 412-8566

Specialties & licenses 6

Addresses

Other identifiers 4

Other names 1

• Wellness Physical Medicine Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Neurosurgery Group P.C.

  dba Wellness Physical Medicine Center

  • Rehabilitation Clinic/Center
  • Clinton Township, MI
  • NPI 1912944893

  2860483690

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Neurosurgery Group, P.C.

  • Specialist
  • Clinton TWP, MI
  • NPI 1275814915

  O20040520001024

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark J Brennan, MD

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Clinton Township, MI
  • NPI 1225001746
  Medicare reassignment NPD

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1386736536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43650 GARFIELD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386332",
            "telephone_number": "586-263-0820",
            "fax_number": "586-263-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43650 GARFIELD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386332",
            "telephone_number": "586-263-0820",
            "fax_number": "586-263-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSURGERY GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "CHISHOLM",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "THERESA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "586-412-8566",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "052399",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "028777",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "405324",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "051833",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002721",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601003971",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437099",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4815088",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891095",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4815097",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Physical Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tia Danine Neal
• Terri Nekoogar, MA LPC
• Luke A Nelson, OTRL
• Nesci Chiropractic, P.C.
• Neurosurgery Group, P.C.
• Jonathan Austin Newby, MSW
• Stacey Newcomb, LMSW
• Next Chapter Therapy Services PLLC
• Nicholas Leone, M.D., P.C.
• Christopher Nicholas, D.O.

• Neurological Surgery Physician in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Neurological Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.