NPIMap

Organization Active NPI

Kidney Care Specialists of Michigan

  • Medical Specialty Clinic/Center
  • Saint Clair Shores, MI
National Provider Identifier
1730570342
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
4301086082 Issued in MI
Legal business name
KIDNEY CARE SPECIALISTS OF MICHIGAN
Practice address
29001 Harper Ave
Saint Clair Shores, MI 48081-2711
Phone
(586) 778-0664
NPI assigned
Feb 18, 2015
Last updated
Feb 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Authorized official

Name
Richard Cross, MDNPI 1972771061
Title
Physician
Phone
(586) 778-0664

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
Medical Specialty Clinic/Center 261QM2500X 4301086082 MI Primary

Addresses

Primary practice location

29001 Harper Ave
Saint Clair Shores, MI 48081-2711

Mailing address

29001 Harper Ave
Saint Clair Shores, MI 48081-2711

National Provider Directory

National Provider Directory
Tax ID family
Kidney Care Specialists of Mi2 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.

Locations

29001 Harper Ave
St Clr Shores, MI 48081
Phone (586) 778-0664

Practitioners & affiliated clinicians

Practitioners 1

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": "1424217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1730570342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29001 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29001 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812711",
            "telephone_number": "586-778-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE SPECIALISTS OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "586-778-0664",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MI",
            "license": "4301086082",
            "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 18, 2015; 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.