NPIMap

Organization Active NPI

Henry Ford West Bloomfield Physicians

  • Family Medicine Physician
  • Walled Lake, MI
National Provider Identifier
1689658221
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
FF007946 Issued in MI
Legal business name
HENRY FORD WEST BLOOMFIELD PHYSICIANS
Practice address
2335 S Commerce Rd
Walled Lake, MI 48390-2136
Phone
(248) 624-1526
Fax
(248) 624-9570
NPI assigned
Dec 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Dr. Frank L Fenton, DONPI 1215081211
Title
Physician
Phone
(248) 624-1526

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: 193400000X SINGLE SPECIALTY GROUP 207Q00000X FF007946 MI Primary

Addresses

Primary practice location

2335 S Commerce Rd
Walled Lake, MI 48390-2136

Mailing address

2335 S Commerce Rd
Walled Lake, MI 48390-2136
Phone (248) 624-1526

Other names 1

  • Walled Lake Medical Center PC Other name

National Provider Directory

National Provider Directory
Tax ID family
Henry Ford Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1689658221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 S COMMERCE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483902136",
            "telephone_number": "248-624-1526",
            "fax_number": "248-624-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 S COMMERCE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483902136",
            "telephone_number": "248-624-1526",
            "fax_number": "248-624-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD WEST BLOOMFIELD PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "FENTON",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "248-624-1526",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "FF007946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walled Lake Medical Center PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Walled Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.