Vinod Kohli MD PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301040989 Issued in MI

Legal business name

VINOD KOHLI MD PC

Practice address

25511 Van Dyke Avenue
Suite 200
Center Line, MI 48015-1834

Phone

(586) 759-6300

Fax

(586) 759-1409

NPI assigned

Nov 14, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Vinod Kohli, M.D.NPI 1770681470

Title

President

Phone

(586) 530-2197

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Vinod Kumar Kohli, M.D.

  • General Practice Physician
  • Center Line, MI
  • NPI 1770681470
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1760636971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25511 VAN DYKE AVENUE",
            "address_2": "SUITE 200",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151834",
            "telephone_number": "586-759-6300",
            "fax_number": "586-759-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25511 VAN DYKE AVENUE",
            "address_2": "SUITE 200",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151834",
            "telephone_number": "586-759-6300",
            "fax_number": "586-759-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINOD KOHLI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-14",
        "last_updated": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "KOHLI",
        "authorized_official_first_name": "VINOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-530-2197",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301040989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0105005271",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MI335057710",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Uselman
• Edward Charles Vahalek
• Ashley Ann Vallone, MSW
• Jamie Vedua
• Christine Vesnaugh, MSN
• Taylor Vranish
• Barbara J. Vultaggio, C.T.R.S.
• Phyllis Caroline Walter, MA, LPC
• Yanyan Wang, DNP, APRN, PMHNP-BC
• Janai Weber

• General Practice Physician in Center Line, MI
• Providers in Center Line, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.