Amd Urgent Care Fenton

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

AMD URGENT CARE FENTON

Practice address

1455 N. Leroy
Fenton, MI 48430

Phone

(810) 564-7995

NPI assigned

Mar 15, 2022

Last updated

Jun 29, 2022By 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

Paul Massimino

Title

Coo

Phone

(810) 564-7995

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 12

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.

• Peter J. Stoyanoff, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Flint, MI
  • NPI 1548359375
  Medicare reassignment Care Compare group NPD
• Mark D. Wilkerson, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Flint, MI
  • NPI 1023114287
  Medicare reassignment Care Compare group NPD
• Alyson Marie Lenz

  • Physician Assistant
  • Fenton, MI
  • NPI 1376231142
  Medicare reassignment Care Compare group
• Montana Boris, PA-C

  • Physician Assistant
  • Clio, MI
  • NPI 1578162277
  Medicare reassignment
• Marygrace Therese Hayden

  • Physician Assistant
  • Clarkston, MI
  • NPI 1487243630
  Medicare reassignment
• Nicole Elisabeth McCullough, PA-C

  • Medical Physician Assistant
  • Swartz Creek, MI
  • NPI 1497388441
  Medicare reassignment
• Brett Austin McGue, PA-C

  • Physician Assistant
  • Clio, MI
  • NPI 1174389621
  Medicare reassignment
• Kori Nunn

  • Physician Assistant
  • Carsonville, MI
  • NPI 1528636305
  Medicare reassignment
• Carlito Robles

  • Physician Assistant
  • Clare, MI
  • NPI 1023686912
  Medicare reassignment
• Eric Paul Rose, PA-C

  • Physician Assistant
  • Kalamazoo, MI
  • NPI 1083123012
  Medicare reassignment
• Katherine Warner, PA-C

  • Physician Assistant
  • Clio, MI
  • NPI 1063040269
  Medicare reassignment
• Gary Fannon, P.A.

  • Medical Physician Assistant
  • Flint, MI
  • NPI 1447512819
  NPD (past)

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1437807807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 N. LEROY",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430",
            "telephone_number": "810-564-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 N. LEROY",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430",
            "telephone_number": "810-564-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMD URGENT CARE FENTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "MASSIMINO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "810-564-7995"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nedil Aldarondo-Antonini, M.D.
• Dalia Ali Khan
• Lynn A Allard, R.N.
• Staci Lynn Allmand, LMSW
• Juan Alvarado, O.D.
• Anderson Chiropractic Group of Michigan Inc.
• Lesli Ann Anderson, LMT, LE
• Scott Kenneth Anderson, D.C.
• Christina Marie Andoni
• Andrea Casey, PH.D., L.P., PLLC

• Urgent Care Clinic/Center in Fenton, MI
• Providers in Fenton, MI by specialty
• Urgent Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.