NPIMap

Organization Active NPI

Prime Garden City Medical Group

  • Internal Medicine Physician
  • Westland, MI
National Provider Identifier
1639391808
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIME GARDEN CITY MEDICAL GROUP
Practice address
8012 Middlebelt Road
Westland, MI 48185
Phone
(734) 425-1225
Fax
(734) 261-0284
NPI assigned
May 3, 2007
Last updated
Feb 7, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
PRIME GARDEN CITY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

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

Authorized official

Name
Mr. John F. Magnuson
Title
Practice Administrator
Phone
(734) 458-4490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

8012 Middlebelt Road
Westland, MI 48185

Mailing address

6245 Inkster Rd
Garden City, MI 48135-4001
Phone (734) 458-4490

National Provider Directory

National Provider Directory
Tax ID family
Amerigard Diagnostic Ce9 organizations share this tax ID, including this one
Part of
Amerigard Diagnostic Ce

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517961600000",
    "number": "1639391808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 INKSTER RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481354001",
            "telephone_number": "734-458-4490",
            "fax_number": "734-458-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8012 MIDDLEBELT ROAD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "48185",
            "telephone_number": "734-425-1225",
            "fax_number": "734-261-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME GARDEN CITY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME GARDEN CITY MEDICAL GROUP",
        "enumeration_date": "2007-05-03",
        "last_updated": "2018-02-07",
        "status": "A",
        "authorized_official_last_name": "MAGNUSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "734-458-4490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; 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.