NPIMap

Individual provider Active NPI

Aurielle Marie Fanning, MD

  • Family Medicine Physician
  • Brighton, MI
National Provider Identifier
1770933574
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301116934 Issued in MI
Practice address
Iha East Brighton Primary Care
5505 S Old US 23 Suite 100
Brighton, MI 48116
Phone
(810) 494-6885
Fax
(313) 369-0142
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301116934 MI Primary

Addresses

Primary practice location

Iha East Brighton Primary Care
5505 S Old US 23 Suite 100
Brighton, MI 48116

Mailing address

24 Frank Lloyd Wright Drive
Suite J2000
Ann Arbor, MI 48105
Phone (734) 747-6766

Other names 1

  • Aurielle Marie McCauley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126001844 MI Practitioner - Family Practice 8527350909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

5505 S Old US
23 Suite 100
Brighton, MI 48116-7524
Phone (810) 494-6885

Hospital & facility affiliations

  • Trinity Health at Home- Southeast Michigan Home health agency, Livonia, MI, CCN 237069
  • Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301116934MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Iha Health Service Corporation CurrentSince Mar 1, 2023 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Family Medicine Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

5505 S Old US 23
Ste 100
Brighton, MI 48116
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

Interoperability endpoints

  • Direct secure messaging: afanning2543767@direct.trinity-health.org

Organizations & group practices 4

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1770933574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "address_2": "SUITE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-747-6766",
            "fax_number": "313-369-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "IHA EAST BRIGHTON PRIMARY CARE",
            "address_2": "5505 S OLD US 23 SUITE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "48116",
            "telephone_number": "810-494-6885",
            "fax_number": "313-369-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "AURIELLE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301116934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AURIELLE",
            "last_name": "MCCAULEY",
            "middle_name": "MARIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.