Fenton Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

51010055954 Issued in MI

Legal business name

FENTON CLINIC

Practice address

201 E Caroline St
129
Fenton, MI 48430-2105

Phone

(810) 629-4187

Fax

(810) 629-9662

NPI assigned

Apr 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Lavern Trollman Jr., DONPI 1811014491

Title

Owner

Phone

(810) 629-4187

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Joseph Lavern Trollman Jr., DO

  • Family Medicine Physician
  • Fenton, MI
  • NPI 1811014491
  NPD (past) Authorized official

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1699949610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E CAROLINE ST",
            "address_2": "129",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302105",
            "telephone_number": "810-629-4187",
            "fax_number": "810-629-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E CAROLINE ST",
            "address_2": "129",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302105",
            "telephone_number": "810-629-4187",
            "fax_number": "810-629-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENTON CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "TROLLMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "LAVERN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-629-4187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "51010055954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MR BC PPOM",
            "identifier": "0152524585",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001880",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fda PC (Fenton Dental Associates)
• Angela Smith Feltz, FNP-C
• Fenton ABA Inc
• Fenton Ados Testing Inc.
• Fenton Behavioral Health Services
• Fenton Family Dental PLLC (Fenton Family Dental)
• Fenton Family Dentistry
• Fenton Family Dentistry PLLC
• Fenton Family Medicine, P.C.
• Fenton Healthcare LLC (Fenton HealthCare)

• Primary Care Clinic/Center in Fenton, MI
• Providers in Fenton, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.