NPIMap

Organization Active NPI

Brightside

  • Primary Care Clinic/Center
  • Farmington Hills, MI
National Provider Identifier
1780450916
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BRIGHTSIDE
Practice address
23143 Julieann CT
Farmington Hills, MI 48335-4076
Phone
(248) 914-6115
NPI assigned
Nov 29, 2023
Last updated
Nov 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Authorized official

Name
Krishna JakkulaNPI 1558719906
Title
Founder
Phone
(248) 914-6115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

23143 Julieann CT
Farmington Hills, MI 48335-4076

Mailing address

23143 Julieann CT
Farmington Hills, MI 48335-4076
Phone (248) 914-6115

National Provider Directory

National Provider Directory

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": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1780450916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23143 JULIEANN CT",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483354076",
            "telephone_number": "248-914-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23143 JULIEANN CT",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483354076",
            "telephone_number": "248-914-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "JAKKULA",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "248-914-6115"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.