Organization Active NPI

My Home Doctors PLLC

  • Health Maintenance Organization
  • Saint Clair Shores, MI
National Provider Identifier
1710250147
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
4301088798 Issued in MI
Legal business name
MY HOME DOCTORS PLLC
Practice address
30140 Harper Ave
Suite 300
Saint Clair Shores, MI 48082-1610
Phone
(586) 359-6983
Fax
(586) 293-1869
NPI assigned
Feb 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Authorized official

Name
Miss Kelly Boekema
Title
Bookkeeper
Phone
(586) 293-1868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 4301088798 MI Primary

Addresses

Primary practice location

30140 Harper Ave
Suite 300
Saint Clair Shores, MI 48082-1610

Mailing address

30140 Harper Ave
Suite 300
Saint Clair Shores, MI 48082-1610
Phone (586) 359-6983

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1710250147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30140 HARPER AVE",
            "address_2": "SUITE 300",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821610",
            "telephone_number": "586-359-6983",
            "fax_number": "586-293-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30140 HARPER AVE",
            "address_2": "SUITE 300",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821610",
            "telephone_number": "586-359-6983",
            "fax_number": "586-293-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY HOME DOCTORS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "BOEKEMA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "586-293-1868",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MI",
            "license": "4301088798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.