Organization Active NPI

Vernor Urgent Care PLLC

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1508205329
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VERNOR URGENT CARE PLLC
Practice address
3456 W Vernor Hwy
Detroit, MI 48216-1551
Phone
(313) 254-9693
Fax
(734) 629-1567
NPI assigned
Jun 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Authorized official

Name
Sameer Abdurrahman Huraibi, MDNPI 1437219391
Title
Medical Director
Phone
(313) 254-9693

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

3456 W Vernor Hwy
Detroit, MI 48216-1551

Mailing address

3456 W Vernor Hwy
Detroit, MI 48216-1551
Phone (313) 254-9693

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140424001421 MI Part B Supplier - Clinic/Group Practice 2466685649 Receives reassigned benefits from 6 practitioners
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory
Tax ID family
Vernor Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3456 W Vernor Hwy
Ste B
Detroit, MI 48216
Phone (313) 789-8934

Practitioners & affiliated clinicians

Practitioners 7

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": "1371168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1508205329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3456 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482161551",
            "telephone_number": "313-254-9693",
            "fax_number": "734-629-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3456 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482161551",
            "telephone_number": "313-254-9693",
            "fax_number": "734-629-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNOR URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-14",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "HURAIBI",
        "authorized_official_first_name": "SAMEER",
        "authorized_official_middle_name": "ABDURRAHMAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "313-254-9693",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.