Individual provider Active NPI

Florence Sri-Tharan, M.D.

  • Family Medicine Physician
  • Lincoln Park, MI
National Provider Identifier
1477545101
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301065409 Issued in MI
Practice address
2255 Fort St
Lincoln Park, MI 48146-2444
Phone
(313) 386-7500
Fax
(313) 386-6447
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301065409 MI Primary

Addresses

Primary practice location

2255 Fort St
Lincoln Park, MI 48146-2444

Mailing address

27774 Franklin Rd
Southfield, MI 48034-2352
Phone (248) 356-5555

Other identifiers 1

IdentifierTypeStateIssuer
4174124-10MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151111000368 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8325177306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1477545101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27774 FRANKLIN RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342352",
            "telephone_number": "248-356-5555",
            "fax_number": "248-356-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462444",
            "telephone_number": "313-386-7500",
            "fax_number": "313-386-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRI-THARAN",
        "first_name": "FLORENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301065409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4174124-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, MI

Sources for this page

Verify at the official NPI Registry.