NPIMap

Organization Active NPI

M-Avis Healthcare Management Service Group LLC

  • Ambulatory Surgical Clinic/Center
  • Southfield, MI
National Provider Identifier
1538470505
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
PENDING Issued in MI
Legal business name
M-AVIS HEALTHCARE MANAGEMENT SERVICE GROUP LLC
Practice address
20240 W 12 Mile Rd
Southfield, MI 48076-2426
Phone
(248) 353-6880
Fax
(734) 692-6195
NPI assigned
Jun 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Authorized official

Name
Ms. Marcia Fosnaugh Avis, R.N.
Title
Director
Phone
(248) 353-6880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X PENDING MI Primary

Addresses

Primary practice location

20240 W 12 Mile Rd
Southfield, MI 48076-2426

Mailing address

20240 W 12 Mile Rd
Southfield, MI 48076-2426
Phone (248) 353-6880

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1538470505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20240 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762426",
            "telephone_number": "248-353-6880",
            "fax_number": "734-692-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20240 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762426",
            "telephone_number": "248-353-6880",
            "fax_number": "734-692-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M-AVIS HEALTHCARE MANAGEMENT SERVICE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-24",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "AVIS",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "FOSNAUGH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "248-353-6880",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "PENDING",
            "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 Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.