NPIMap

Organization Active NPI

Complex Care Consultants LLC

Doing business as ComplexCare360

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Novi, MI
National Provider Identifier
1467076273
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
COMPLEX CARE CONSULTANTS LLC
Doing business as
ComplexCare360
Practice address
23767 Maude Lea St
Novi, MI 48375-3540
Phone
(248) 787-1862
NPI assigned
Jun 8, 2020
Last updated
Jun 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Authorized official

Name
Tamara Ann Ford
Title
Managing Partner
Phone
(248) 787-1862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary

Addresses

Primary practice location

23767 Maude Lea St
Novi, MI 48375-3540

Mailing address

PO Box 654
Northville, MI 48167-0654

Other names 1

  • ComplexCare360 Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL complexcare360@gmail.com Health Information Exchange (HIE)
CONNECT URL complexcare360@gmail.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1467076273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 654",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481670654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23767 MAUDE LEA ST",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753540",
            "telephone_number": "248-787-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLEX CARE CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "248-787-1862"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "complexcare360@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "23767 Maude Lea St",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483753540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "complexcare360@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "23767 Maude Lea St",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483753540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ComplexCare360",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.