Active NPI
Midwesthealthcenter
- General Practice Physician
- Dearborn, MI
National Provider Identifier
1497931695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- MIDWESTHEALTHCENTER
- Practice address
- 5050 Schaefer Rd
Dearborn, MI 48126-3249 - Phone
- (313) 581-2600
- Fax
- (313) 581-0228
- NPI assigned
- Jan 17, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lee Ann Odom
- Title
- President Shared Services
- Phone
- (947) 522-3326
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | MI | Primary |
Addresses
Primary practice location
5050 Schaefer Rd
Dearborn, MI 48126-3249
Mailing address
26901 Beaumont Blvd
Compliance
Southfield, MI 48033-3849
Phone (947) 522-1964
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3098064 | Medicaid | MI | |
| 0H261900 | Other | MI | BCBSM |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1634774400000",
"number": "1497931695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD",
"address_2": "COMPLIANCE",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849",
"telephone_number": "947-522-1964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 SCHAEFER RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481263249",
"telephone_number": "313-581-2600",
"fax_number": "313-581-0228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDWESTHEALTHCENTER",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-17",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A",
"authorized_official_last_name": "ODOM",
"authorized_official_first_name": "LEE",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "PRESIDENT SHARED SERVICES",
"authorized_official_telephone_number": "947-522-3326"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3098064",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "0H261900",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.