Mid Michigan Home Visiting Doctors LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MID MICHIGAN HOME VISITING DOCTORS LLC

Practice address

640 Romence Rd
Suite 215
Portage, MI 49024-3464

Phone

(269) 321-3300

NPI assigned

Sep 1, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Omar

Title

Vice President

Phone

(313) 862-8050

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Raafat Boles Mahrous Shehata, M.D.

  • Family Medicine Physician
  • Southfield, MI
  • NPI 1891078846

  General Practice

  NPD
• Tessy Mathew, NP

  • Adult Health Nurse Practitioner
  • Temple, TX
  • NPI 1669537189
  NPD (past)

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1790092500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40420",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482400420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ROMENCE RD",
            "address_2": "SUITE 215",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243464",
            "telephone_number": "269-321-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID MICHIGAN HOME VISITING DOCTORS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "313-862-8050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael V Bloom PHD LLC
• Michelle Hanson
• Michigan Integrated Therapies
• Michigan Integrated Therapies
• Michigan Senior Care Inc.
• Mid-America Psychological Services, P. C.
• Midwest Family Dental Care Portage PC
• Jackquline Mileski, BSW
• Rylee Miller-Lewis, PA-C
• Allison Miller

• General Practice Physician in Portage, MI
• Providers in Portage, 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 Dec 1, 2011; 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.