Family Medical Center of Michigan
Organization Active NPI Federally Qualified Health Center (FQHC) · Monroe, MI
NPI 1689032385 · NPPES record last updated Nov 18, 2019
Key facts
- NPI
- 1689032385
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- FAMILY MEDICAL CENTER OF MICHIGAN
- Practice address
- 901 N Macomb St
Monroe, MI 48162-3088 - Phone
- (734) 240-4851
- Fax
- (734) 240-4854
- NPI assigned
- Feb 9, 2016
- Organization subpart
- No
Authorized official
- Name
- Mr. Ed Larkins
- Title
- Ceo
- Phone
- (734) 850-6914
Other NPIs on the same Medicare enrollment 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070910000059 | MI | Part B Supplier - Clinic/Group Practice | 2769575653 |
Receives reassigned benefits from 35 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Adrian, MI; Carleton, MI; Monroe, MI; Temperance, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | MI | Yes |
Addresses
Primary practice location
901 N Macomb St
Monroe, MI 48162-3088
Mailing address
8765 Lewis Ave
Temperance, MI 48182-9583
Phone (734) 847-3802
Other names
- Family Medical Center of Mi-Monroe II
NPI Registry JSON
{
"created_epoch": "1454976000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1574035200000",
"number": "1689032385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8765 LEWIS AVE",
"city": "TEMPERANCE",
"state": "MI",
"postal_code": "481829583",
"telephone_number": "734-847-3802",
"fax_number": "734-847-3418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 N MACOMB ST",
"city": "MONROE",
"state": "MI",
"postal_code": "481623088",
"telephone_number": "734-240-4851",
"fax_number": "734-240-4854"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY MEDICAL CENTER OF MICHIGAN",
"organizational_subpart": "NO",
"enumeration_date": "2016-02-09",
"last_updated": "2019-11-18",
"status": "A",
"authorized_official_last_name": "LARKINS",
"authorized_official_first_name": "ED",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "734-850-6914",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Family Medical Center of Mi-Monroe II",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Family Medical Center of Mi-Monroe II",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Monroe, MI
- Emily Evans
- Jammie Lynn Evans
- Patricia J Evans
- Family Counseling & Shelter Services
- Family Counseling and Shelter Services of Monroe County
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan, Inc
All providers in Monroe, MI · Federally Qualified Health Center (FQHC) in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.