NPIMap

Organization Active NPI

Physicians Residential Services, P.C.

  • General Practice Physician
  • Eastpointe, MI
National Provider Identifier
1700866811
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301068676 Issued in MI
Legal business name
PHYSICIANS RESIDENTIAL SERVICES, P.C.
Practice address
20927 Kelly Rd
Eastpointe, MI 48021-3128
Phone
(586) 777-8801
Fax
(586) 777-9988
NPI assigned
Jan 17, 2006
Last updated
Dec 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Authorized official

Name
Dr. Edwin J Soler-Valcourt, M.D.NPI 1326028135
Title
President
Phone
(586) 777-8801

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4301068676 MI Primary

Addresses

Primary practice location

20927 Kelly Rd
Eastpointe, MI 48021-3128

Mailing address

20927 Kelly Rd
Eastpointe, MI 48021-3128
Phone (586) 777-8801

Other identifiers 7

IdentifierTypeStateIssuer
010066340OtherRAILROAD MEDICARE
010E010070OtherBCBSM
135198828MedicaidMI
104784286MedicaidMI
P00298680OtherRAILROAD MEDICARE
104676117MedicaidMI
P00405274OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

20927 Kelly Rd
Ste 3
Eastpointe, MI 48021
Phone (586) 777-8801

23420 Greater Mack Ave
Fl 2
St Clr Shores, MI 48080
Phone (586) 447-9729

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1700866811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20927 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213128",
            "telephone_number": "586-777-8801",
            "fax_number": "586-777-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20927 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213128",
            "telephone_number": "586-777-8801",
            "fax_number": "586-777-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS RESIDENTIAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "SOLER-VALCOURT",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-777-8801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301068676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010066340",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "010E010070",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135198828",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104784286",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00298680",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104676117",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00405274",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; 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.