Organization Active NPI

Family First Wellness Center, PLLC

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1487362224
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY FIRST WELLNESS CENTER, PLLC
Practice address
24777 Greenfield Rd Ste 202
Southfield, MI 48075-3065
Phone
(248) 554-1313
NPI assigned
Nov 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
Ralph Edward WilliamsNPI 1396942454
Title
Authorized Official
Phone
(248) 554-1313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

24777 Greenfield Rd Ste 202
Southfield, MI 48075-3065

Mailing address

24777 Greenfield Rd Ste 202
Southfield, MI 48075-3065
Phone (248) 554-1313

Other practice location 1

24777 Greenfield Rd Ste 2
Southfield, MI 48075-3065
Phone (248) 554-1313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230126001177 MI Part B Supplier - Clinic/Group Practice 9739550922 Receives reassigned benefits from 4 practitioners
Practice locations: Southfield, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2283681Family First Wellness Center24777 Greenfield Road Suite 202, Southfield, MI 48075Certificate of waiverJun 11, 2027

National Provider Directory

National Provider Directory

Locations

24777 Greenfield Rd
Ste 2
Southfield, MI 48075
Phone (248) 554-1313

Practitioners & affiliated clinicians

Practitioners 5

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": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1487362224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24777 GREENFIELD RD STE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753065",
            "telephone_number": "248-554-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24777 GREENFIELD RD STE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753065",
            "telephone_number": "248-554-1313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24777 Greenfield Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480753065",
            "country_code": "US",
            "telephone_number": "248-554-1313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY FIRST WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "248-554-1313"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "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 Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.