NPIMap

Organization Active NPI

Henry Ford Health Genesys Hospital

Doing business as Henry Ford Radiology and imaging

  • Diagnostic Radiology Physician
  • Grand Blanc, MI
National Provider Identifier
1609747542
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
HENRY FORD HEALTH GENESYS HOSPITAL
Doing business as
Henry Ford Radiology and imaging
Practice address
600 Health Park Blvd Ste B
Grand Blanc, MI 48439-2558
Phone
(810) 606-1601
Fax
(810) 249-4316
NPI assigned
Sep 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Authorized official

Name
Kimberly Cebalt
Title
Manager of Provider Affairs
Phone
(313) 874-6764

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Therapeutic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0203X

Addresses

Primary practice location

600 Health Park Blvd Ste B
Grand Blanc, MI 48439-2558

Mailing address

PO Box 670884
Detroit, MI 48267-0884
Phone (800) 999-5829

Other practice location 1

4154 W Vienna Rd
Clio, MI 48420-2809
Phone (810) 564-1000

Other practice location 2

1096 S Belsay Rd Ste C
Burton, MI 48509-1948
Phone (810) 715-0803

Other names 1

  • Henry Ford Radiology and imaging Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081029000720 MI Part B Supplier - Clinic/Group Practice 2062323033 Receives reassigned benefits from 153 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burton, MI; Clio, MI; Grand Blanc, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Clifford C Douglas MD37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1609747542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670884",
            "telephone_number": "800-999-5829",
            "fax_number": "248-641-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HEALTH PARK BLVD STE B",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392558",
            "telephone_number": "810-606-1601",
            "fax_number": "810-249-4316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4154 W Vienna Rd",
            "address_purpose": "LOCATION",
            "city": "Clio",
            "state": "MI",
            "postal_code": "484202809",
            "country_code": "US",
            "telephone_number": "810-564-1000",
            "fax_number": "810-564-2645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1096 S Belsay Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Burton",
            "state": "MI",
            "postal_code": "485091948",
            "country_code": "US",
            "telephone_number": "810-715-0803",
            "fax_number": "810-715-0824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HENRY FORD HEALTH GENESYS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-15",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "CEBALT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MANAGER OF PROVIDER AFFAIRS",
        "authorized_official_telephone_number": "313-874-6764"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Therapeutic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Radiology and imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.