Jerome Wilborn, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301057004 Issued in MI

Practice address

28050 Grand River Ave
Farmington Hills, MI 48336-5919

Phone

(734) 464-0887

Fax

(734) 402-0254

NPI assigned

Jan 25, 2006

Last updated

Jul 29, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, TX, IL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inpatient Consultants of Michigan PC

  • Hospitalist Physician
  • Livonia, MI
  • NPI 1861442824

  Internal Medicine

  Medicare reassignment NPD
• Transitions of Care, PLLC

  • Internal Medicine Physician
  • Ann Arbor, MI
  • NPI 1710289665
  NPD (past) Authorized official
• Continuum Geriatric Services PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Brighton, MI
  • NPI 1568625366

  Internal Medicine

  NPD (past)
• Continuum Psychiatric Services, LLP

  • Geriatric Psychiatry Physician
  • Livonia, MI
  • NPI 1023288669
  NPD (past)
• Midwest Physician Services PC

  dba Physician Services of Michigan

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1215945878

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1750351516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36123 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28050 GRAND RIVER AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365919",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBORN",
        "first_name": "JEROME",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301057004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4637100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Wight
• Megan Wightman
• Christopher Wiitanen
• Tearnee Wilbert
• Chandra Wilbon
• Capria Wilbourn
• Jeffrey Wilbur, OTL, CSCS
• Allison Wilburn
• Amari Wilburn
• Amethyst Wilburn

• Internal Medicine Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.