Michigan Neurosurgical Institute PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MICHIGAN NEUROSURGICAL INSTITUTE PC

Practice address

4620 Genesys Pkwy
Grand Blanc, MI 48439-8067

Phone

(810) 606-7200

Fax

(810) 606-7115

NPI assigned

Apr 28, 2008

Last updated

Jan 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa V Scott

Title

Practice Manager

Phone

(810) 606-7112

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Avery Michael Jackson III, M.D.

  • Neurological Surgery Physician
  • Grand Blanc, MI
  • NPI 1851329197
  NPD

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1598930968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398067",
            "telephone_number": "810-606-7200",
            "fax_number": "810-606-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398067",
            "telephone_number": "810-606-7200",
            "fax_number": "810-606-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN NEUROSURGICAL INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "810-606-7112"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "540B515610",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Mena Michail, DO
• Michigan Dental Wellness Center PLLC
• Michigan Independent Physicians Association, PLC (Michigan IPA)
• Michigan Lung and Critical Care Specialists, PC
• Michigan Maternal Fetal Medicine PLC
• Michigan Neurosurgical Institute, P.C
• Michigan Rheumatology Group PC
• Mid Michigan Center for Sleep Disorders Inc
• Mid Michigan Imaging Services LLC
• Mid-Michigan Hospitalist Group PC

• Durable Medical Equipment & Medical Supplies in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.