NPIMap

Organization Active NPI

Advanced Medical House Calls, PLC

  • Adult Medicine Physician
  • Fenton, MI
National Provider Identifier
1508201013
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
ADVANCED MEDICAL HOUSE CALLS, PLC
Practice address
14165 N Fenton Rd Ste 201a
Fenton, MI 48430-1584
Phone
(810) 853-5875
Fax
(586) 279-4515
NPI assigned
May 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Authorized official

Name
Dr. Mark D Wilkerson, M.D.NPI 1023114287
Title
President
Phone
(810) 853-5875

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
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

14165 N Fenton Rd Ste 201a
Fenton, MI 48430-1584

Mailing address

14165 N. Fenton Road
Suite 201a
Fenton, MI 48430-1128
Phone (810) 853-5875

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130905000697 MI Part B Supplier - Clinic/Group Practice 0042453318 Receives reassigned benefits from 9 practitioners
Practice locations: Fenton, MI

National Provider Directory

National Provider Directory

Locations

700 N Leroy St
Fenton, MI 48430
Phone (810) 853-5875

14165 N Fenton Rd
Ste 201A
Fenton, MI 48430
Phone (810) 853-5875

Practitioners & affiliated clinicians

Practitioners 10

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": "1368144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530835200000",
    "number": "1508201013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14165 N. FENTON ROAD",
            "address_2": "SUITE 201A",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301128",
            "telephone_number": "810-853-5875",
            "fax_number": "586-279-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14165 N FENTON RD STE 201A",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301584",
            "telephone_number": "810-853-5875",
            "fax_number": "586-279-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL HOUSE CALLS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-10",
        "last_updated": "2018-07-06",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-853-5875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.