NPIMap

Organization Active NPI

The Wellness Plan Medical Centers

Doing business as East Medical Center

  • Clinic/Center
  • Detroit, MI
National Provider Identifier
1427416783
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
THE WELLNESS PLAN MEDICAL CENTERS
Doing business as
East Medical Center
Practice address
4909 E Outer Dr
Detroit, MI 48234-3446
Phone
(313) 366-2000
Fax
(313) 369-3952
NPI assigned
Feb 2, 2016
Last updated
Sep 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Anthony V King
Title
Ceo and Executive Director
Phone
(313) 202-8550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

4909 E Outer Dr
Detroit, MI 48234-3446

Mailing address

4909 E Outer Dr
Detroit, MI 48234-3446
Phone (313) 202-8660

Other identifiers 1

IdentifierTypeStateIssuer
OM37210MedicaidMI

Other names 1

  • East Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Health SV10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1427416783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 E OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343446",
            "telephone_number": "313-202-8660",
            "fax_number": "313-202-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 E OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343446",
            "telephone_number": "313-366-2000",
            "fax_number": "313-369-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS PLAN MEDICAL CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CEO AND EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-202-8550"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OM37210",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 3, 2020; 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.