Active NPI
Michael Wilson, BS
- Case Manager/Care Coordinator
- Southfield, MI
National Provider Identifier
1467828350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 30500 Southfield Road Apt. 200
Michael Wilson
Southfield, MI 48076 - Phone
- (313) 255-0900
- Fax
- (313) 255-3465
- NPI assigned
- Aug 14, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
30500 Southfield Road Apt. 200
Michael Wilson
Southfield, MI 48076
Mailing address
17321 Telegraph Road
Development Centers
Detroit, MI 48219
Phone (313) 255-0900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439510400000",
"number": "1467828350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17321 TELEGRAPH ROAD",
"address_2": "DEVELOPMENT CENTERS",
"city": "DETROIT",
"state": "MI",
"postal_code": "48219",
"telephone_number": "313-255-0900",
"fax_number": "313-255-3465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30500 SOUTHFIELD ROAD APT. 200",
"address_2": "MICHAEL WILSON",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48076",
"telephone_number": "313-255-0900",
"fax_number": "313-255-3465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-14",
"last_updated": "2015-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.