NPIMap

Organization Active NPI

Prime Garden City Medical Group

Doing business as Center for Sports and Family Medicine

  • Sports Medicine (Family Medicine) Physician
  • Westland, MI
National Provider Identifier
1427208537
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
PRIME GARDEN CITY MEDICAL GROUP
Doing business as
Center for Sports and Family Medicine
Practice address
35600 Central City Pkwy
Suite 104
Westland, MI 48185-2046
Phone
(734) 261-3778
Fax
(734) 524-0981
NPI assigned
Sep 25, 2008
Last updated
Apr 12, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
PRIME GARDEN CITY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Authorized official

Name
Mr. John F Magnuson
Title
Practice Administrator
Phone
(734) 458-4490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X Primary

Addresses

Primary practice location

35600 Central City Pkwy
Suite 104
Westland, MI 48185-2046

Mailing address

35600 Central City Pkwy
Suite 104
Westland, MI 48185-2046
Phone (734) 261-3778

Other names 1

  • Center for Sports and Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prime Garden City Med Group9 organizations share this tax ID, including this one
Part of
Prime Garden City Med Group

Other organizations with this tax ID 8

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": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1427208537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35600 CENTRAL CITY PKWY",
            "address_2": "SUITE 104",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481852046",
            "telephone_number": "734-261-3778",
            "fax_number": "734-524-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35600 CENTRAL CITY PKWY",
            "address_2": "SUITE 104",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481852046",
            "telephone_number": "734-261-3778",
            "fax_number": "734-524-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME GARDEN CITY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME GARDEN CITY MEDICAL GROUP",
        "enumeration_date": "2008-09-25",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "MAGNUSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "734-458-4490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Sports and Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.