The Wellness Plan Medical Centers

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

THE WELLNESS PLAN MEDICAL CENTERS

Practice address

44405 Woodward Ave
Suite H-13
Pontiac, MI 48341-5023

Phone

(248) 858-3126

Fax

(248) 858-6499

NPI assigned

Feb 27, 2014

Organization subpart

No

Name

Mr. Anthony V King

Title

Ceo and Executive Director

Phone

(313) 202-8550

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• The Wellness Plan Medical Centers

  • Clinic/Center
  • Detroit, MI
  • NPI 1043373244

  O20040925000098

  Same enrollment

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

• Cecilia Cristina Cosma, M.D.

  • Internal Medicine Physician
  • Bloomfield Hills, MI
  • NPI 1992973721
  NPD
• Benjamin John Diaczok I, MD

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1760480834
  NPD
• Monica Nicola, MD

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1477522357
  NPD
• Chaka Chipawe, NP-C

  • Adult Health Nurse Practitioner
  • White Lake, MI
  • NPI 1104378264
  NPD (past)
• Latanya S Cross

  • Nurse Practitioner
  • Southfield, MI
  • NPI 1396140372
  NPD (past)
• Rajinder Grewal

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1437327350
  NPD (past)
• Karisa Harris-Turner, MSW

  • Clinical Social Worker
  • Detroit, MI
  • NPI 1700133196
  NPD (past)
• Vijaya Kiran Kaza, MD

  • Pediatrics Physician
  • Farmington Hills, MI
  • NPI 1851392625
  NPD (past)
• Ashleigh Singleton, LMSW

  • Clinical Social Worker
  • Novi, MI
  • NPI 1053844795
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MI

• The Henderson Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 12, 2019.

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1447675434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 2ND AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022411",
            "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": "44405 WOODWARD AVE",
            "address_2": "SUITE H-13",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3126",
            "fax_number": "248-858-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS PLAN MEDICAL CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-27",
        "last_updated": "2019-02-12",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Henderson Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Henderson Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christy Marie Thallman, MSN RN FNP
• Lukose K Thampy, DO
• The Art Experience, Inc.
• The Medical Team, Inc.
• The Wellness Plan Medical Centers
• Theramatrix, Inc.
• Logan Thirkill
• Varshini Thiruvadi, M.D.
• Thomas Mathew MD PLLC
• Beverly V Thomas

• All providers in Pontiac, MI
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.