NPIMap

Organization Active NPI

Kairos Healthcare Incorporated

  • Social Worker
  • Taylor, MI
National Provider Identifier
1750457958
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
823011 Issued in MI
Legal business name
KAIROS HEALTHCARE INCORPORATED
Practice address
20400 Superior Rd
Taylor, MI 48180-5362
Phone
(734) 374-2400
Fax
(734) 374-8360
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Authorized official

Name
Mr. Fred E. Wigen Jr.
Title
President Ceo
Phone
(989) 777-4357

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 823011 MI
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 823011 MI
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 823011 MI Primary

Addresses

Primary practice location

20400 Superior Rd
Taylor, MI 48180-5362

Mailing address

6379 Dixie Hwy
Bridgeport, MI 48722-9566
Phone (989) 777-4357

National Provider Directory

National Provider Directory
Tax ID family
Kairos Healthcare Incorporated5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

20400 Superior Rd
Taylor, MI 48180
Phone (734) 282-7171

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1750457958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6379 DIXIE HWY",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229566",
            "telephone_number": "989-777-4357",
            "fax_number": "989-777-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20400 SUPERIOR RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481805362",
            "telephone_number": "734-374-2400",
            "fax_number": "734-374-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIROS HEALTHCARE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "WIGEN",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT  CEO",
        "authorized_official_telephone_number": "989-777-4357",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MI",
            "license": "823011",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "823011",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "823011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; 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.