NPIMap

Organization Active NPI

Michigan Wellness 1 LLC

  • Primary Care Clinic/Center
  • Detroit, MI
National Provider Identifier
1437711595
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MICHIGAN WELLNESS 1 LLC
Practice address
18455 James Couzens Fwy
Detroit, MI 48235-2506
Phone
(313) 204-8911
NPI assigned
Jun 28, 2019
Last updated
Jun 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Authorized official

Name
Cynthia MuhammadNPI 1326489212
Title
Ceo
Phone
(313) 204-8911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

18455 James Couzens Fwy
Detroit, MI 48235-2506

Mailing address

3500 E Jefferson Ave Apt 524
Detroit, MI 48207-4479

National Provider Directory

National Provider Directory

Locations

18455 James Couzens Fwy
Detroit, MI 48235
Phone (313) 204-8911

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1437711595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 E JEFFERSON AVE APT 524",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18455 JAMES COUZENS FWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352506",
            "telephone_number": "313-204-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN WELLNESS 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A",
        "authorized_official_last_name": "MUHAMMAD",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-204-8911"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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 Jun 28, 2019; 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.