NPIMap

Organization Active NPI

Family Medical Center of Michigan

Doing business as Family Medical Center of Mi-Monroe II

  • Federally Qualified Health Center (FQHC)
  • Monroe, MI
National Provider Identifier
1689032385
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY MEDICAL CENTER OF MICHIGAN
Doing business as
Family Medical Center of Mi-Monroe II
Practice address
901 N Macomb St
Monroe, MI 48162-3088
Phone
(734) 240-4851
Fax
(734) 240-4854
NPI assigned
Feb 9, 2016
Last updated
Nov 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Authorized official

Name
Mr. Ed Larkins
Title
Ceo
Phone
(734) 850-6914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X MI Primary

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 1

  • Family Medical Center of Mi-Monroe II Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.