NPIMap

Organization Active NPI

Envision Medical Group PLLC

  • Family Medicine Physician
  • Northville, MI
National Provider Identifier
1578891750
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ENVISION MEDICAL GROUP PLLC
Practice address
42931 7 Mile Rd
Northville, MI 48167-2277
Phone
(248) 348-8700
NPI assigned
Nov 25, 2009
Last updated
Jan 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Authorized official

Name
Michael Wayne, DONPI 1629177035
Title
Managing Member
Phone
(248) 741-6909

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 23D0368331 MI
Physician Assistant 363A00000X NU
Registered Dietitian 133V00000X NU
Family Medicine Physician 207Q00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Diagnostic Radiology Physician 2085R0202X NU
Primary Podiatric Medicine Podiatrist 213EP1101X NU

Addresses

Primary practice location

42931 7 Mile Rd
Northville, MI 48167-2277

Mailing address

PO Box 27420
Belfast, ME 04915-2026

National Provider Directory

National Provider Directory

Locations

33400 6 Mile Rd
Ste B
Livonia, MI 48152
Phone (734) 452-7111

422 N Center St
Northville, MI 48167
Phone (248) 348-1131

422 N Center St
Ste B
Northville, MI 48167
Phone (248) 449-7156

39475 Lewis Dr
Ste 110
Novi, MI 48377
Phone (248) 471-0675

22024 Pontiac Trl
South Lyon, MI 48178
Phone (248) 348-8700

Practitioners & affiliated clinicians

Practitioners 72

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1578891750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27420",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049152026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42931 7 MILE RD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481672277",
            "telephone_number": "248-348-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "WAYNE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "248-741-6909",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D0368331",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

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

Verify at the official NPI Registry.