Facilicare Clinical Michigan PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FACILICARE CLINICAL MICHIGAN PLLC

Practice address

122 E Brown St
Birmingham, MI 48009-6201

Phone

(248) 845-4237

NPI assigned

May 7, 2024

Organization subpart

No

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

Authorized official

Name

Jylnelle Fearson

Title

Credentialing Specialist

Phone

(248) 845-4237

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Thomas Zaidan, M.D.

  • Obstetrics & Gynecology Physician
  • Lake Orion, MI
  • NPI 1619905387
  Medicare reassignment NPD

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1508614447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2137",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480122137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E BROWN ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096201",
            "telephone_number": "248-845-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACILICARE CLINICAL MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "FEARSON",
        "authorized_official_first_name": "JYLNELLE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "248-845-4237"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eversafe LLC
• Evo Body Image, LLC
• Executive Concierge Transportation LLC
• Exquisite Medical Solutions
• Stephen Dillon Fabick, ED.D.
• Jonathan David Falk, PH.D.
• Falyne J. Fry, M.D., P.L.C
• Talitha A Farah, LCSW
• Jeanette Faria, BS, RRT, RPFT, IHP2
• Steven Feldman, M.D.

• Clinic/Center in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.