NPIMap

Organization Active NPI

Oakland Integrated Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pontiac, MI
National Provider Identifier
1457711202
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OAKLAND INTEGRATED HEALTHCARE NETWORK
Practice address
1701 Baldwin Ave
Pontiac, MI 48340-3412
Phone
(248) 724-7600
NPI assigned
Mar 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Authorized official

Name
Debra Brinson
Title
Ceo
Phone
(248) 724-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1701 Baldwin Ave
Pontiac, MI 48340-3412

Mailing address

PO Box 430150
Pontiac, MI 48343-0150
Phone (248) 724-7600

Other names 1

  • OIHN Baldwin Family Medicine Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120611000523 MI Part B Supplier - Clinic/Group Practice 9436313004 Receives reassigned benefits from 47 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pontiac, MI; Waterford, MI; Southfield, MI
O20160324001456 MI Part A Provider - Federally Qualified Health Center (FQHC) 9436313004 Practice locations: Pontiac, MI

Federally qualified health center certification: CCN 231091

Legal name
OAKLAND INTEGRATED HEALTHCARE NETWORK
Doing business as
OIHN - BALDWIN CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 23, 2016
Last certification
Mar 23, 2016
Ownership / control type
For profit – corporation
Organization structure
LLCNon-profit
Incorporated
May 20, 2011 in MI
Enrollment address
1701 Baldwin Ave
Pontiac, MI 48340-3412

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Oakland Integrated Network24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

48980 Woodward Ave
Pontiac, MI 48342
Phone (248) 724-7400

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Debra Brinson Individual Corporate Officer Oct 1, 2014
W-2 Managing Employee Oct 1, 2014

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1457711202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430150",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483430150",
            "telephone_number": "248-724-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 BALDWIN AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483403412",
            "telephone_number": "248-724-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAND INTEGRATED HEALTHCARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "BRINSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-724-7600"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OIHN Baldwin Family Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.