NPIMap

Organization Active NPI

The Wellness Plan Medical Centers

Doing business as The Wellness Plan

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1649229287
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301038485 Issued in MI
Legal business name
THE WELLNESS PLAN MEDICAL CENTERS
Doing business as
The Wellness Plan
Practice address
2888 W Grand Blvd
Detroit, MI 48202-2612
Phone
(313) 875-4200
Fax
(313) 875-5611
NPI assigned
May 10, 2006
Last updated
Aug 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Authorized official

Name
Anthony V King
Title
Ceo & Executive Director
Phone
(313) 202-8660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301038485 MI Primary

Addresses

Primary practice location

2888 W Grand Blvd
Detroit, MI 48202-2612

Mailing address

2888 W Grand Blvd
Detroit, MI 48202-2612

Other identifiers 2

IdentifierTypeStateIssuer
5078418MedicaidMI
1720123029OtherMINPI

Other names 1

  • The Wellness Plan Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Health SV10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1649229287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2888 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022612",
            "telephone_number": "313-875-4200",
            "fax_number": "313-875-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS PLAN MEDICAL CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CEO & EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-202-8660"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301038485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5078418",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720123029",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wellness Plan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.