Organization Active NPI

Whitmore Lake Health Clinic

  • Internal Medicine Physician
  • Whitmore Lake, MI
National Provider Identifier
1790901304
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WHITMORE LAKE HEALTH CLINIC
Practice address
9690 E Mi State Road 36
Whitmore Lake, MI 48189-9703
Phone
(734) 449-2033
Fax
(734) 449-7186
NPI assigned
Apr 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Hilda M. Ely
Title
Executive Director
Phone
(734) 449-2033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MI Primary

Addresses

Primary practice location

9690 E Mi State Road 36
Whitmore Lake, MI 48189-9703

Mailing address

9690 E Mi State Road 36
PO Box 606
Whitmore Lake, MI 48189-9703
Phone (734) 449-2033

National Provider Directory

National Provider Directory

Locations

9690 E MI State Road 36
Whitmore Lake, MI 48189
Phone (734) 449-2033

Practitioners & affiliated clinicians

Practitioners 3

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": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790901304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9690 E MI STATE ROAD 36",
            "address_2": "PO BOX 606",
            "city": "WHITMORE LAKE",
            "state": "MI",
            "postal_code": "481899703",
            "telephone_number": "734-449-2033",
            "fax_number": "734-449-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9690 E MI STATE ROAD 36",
            "city": "WHITMORE LAKE",
            "state": "MI",
            "postal_code": "481899703",
            "telephone_number": "734-449-2033",
            "fax_number": "734-449-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITMORE LAKE HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELY",
        "authorized_official_first_name": "HILDA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "734-449-2033",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitmore Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.