Organization Active NPI

Tri-County Physician Group PC

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1386942035
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TRI-COUNTY PHYSICIAN GROUP PC
Practice address
3011 W Grand Blvd
Suite 307
Detroit, MI 48202-3096
Phone
(313) 986-1011
NPI assigned
Mar 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Authorized official

Name
Kelly Owens
Title
Administration
Phone
(313) 986-1011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3011 W Grand Blvd
Suite 307
Detroit, MI 48202-3096

Mailing address

3011 W Grand Blvd
Suite 307
Detroit, MI 48202-3096
Phone (313) 986-1011

National Provider Directory

National Provider Directory

Locations

3011 W Grand Blvd
Ste 307
Detroit, MI 48202
Phone (313) 832-8008

2100 W Alexis Rd
Ste B3
Toledo, OH 43613
Phone (419) 458-3686

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1386942035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 W GRAND BLVD",
            "address_2": "SUITE 307",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023096",
            "telephone_number": "313-986-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 W GRAND BLVD",
            "address_2": "SUITE 307",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023096",
            "telephone_number": "313-986-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY PHYSICIAN GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-04",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "313-986-1011"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 26, 2016; 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.