Organization Active NPI

Bedside Manners Home Care

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1669709416
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BEDSIDE MANNERS HOME CARE
Practice address
21650 W 11 Mile Rd
Ste 207a
Southfield, MI 48075-2851
Phone
(313) 879-9301
Fax
(855) 516-8881
NPI assigned
Nov 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Mrs. Tanaquil PowersNPI 1922776285
Title
Administrator
Phone
(313) 879-9301

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

21650 W 11 Mile Rd
Ste 207a
Southfield, MI 48075-2851

Mailing address

PO Box 37523
Oak Park, MI 48237-0523
Phone (313) 879-9301

Other identifiers 2

IdentifierTypeStateIssuer
1669709416MedicaidMI
0H257080OtherMIBCBS

National Provider Directory

National Provider Directory

Locations

19200 Ecorse Rd
Ste 102
Allen Park, MI 48101
Phone (313) 383-6059

10000 Wayne Rd
Ste 107
Romulus, MI 48174
Phone (313) 879-9301

24100 Southfield Rd
Ste 204
Southfield, MI 48075
Phone (248) 242-5545

21650 W 11 Mile Rd
Ste 207
Southfield, MI 48076
Phone (313) 879-9301

21650 W 11 Mile Rd
Ste 207A
Southfield, MI 48076
Phone (313) 879-9301

24100 Southfield Rd
Ste 20
Southfield, MI 48075

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1669709416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37523",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482370523",
            "telephone_number": "313-879-9301",
            "fax_number": "855-516-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21650 W 11 MILE RD",
            "address_2": "STE 207A",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752851",
            "telephone_number": "313-879-9301",
            "fax_number": "855-516-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDSIDE MANNERS HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "TANAQUIL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-879-9301",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669709416",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0H257080",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.