NPIMap

Organization Active NPI

Family Medical Center of Michigan,Inc

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
National Provider Identifier
1699447771
Registry record updated Sep 28, 2021
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,INC
Practice address
19955 Fenelon St
Detroit, MI 48234-2273
Phone
(734) 847-3802
Fax
(734) 850-0520
NPI assigned
Sep 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

19955 Fenelon St
Detroit, MI 48234-2273

Mailing address

8765 Lewis Ave
Temperance, MI 48182-9300
Phone (734) 847-3802

Other names 1

  • FAMILY MEDICAL CENTER OF MICHIGAN-MASON ACADEMY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Famly Medical Center of Michigan Inc91 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

19955 Fenelon St
Detroit, MI 48234

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1699447771",
    "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": "481829300",
            "telephone_number": "734-847-3802",
            "fax_number": "734-850-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19955 FENELON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482342273",
            "telephone_number": "734-847-3802",
            "fax_number": "734-850-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER OF MICHIGAN,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY MEDICAL CENTER OF MICHIGAN-MASON ACADEMY",
            "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 Sep 28, 2021; 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.