Organization Active NPI

Envision Medical Group PLLC

  • Family Medicine Physician
  • Northville, MI
National Provider Identifier
1821391848
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ENVISION MEDICAL GROUP PLLC
Practice address
422 N Center St
Northville, MI 48167-1224
Phone
(248) 348-1131
NPI assigned
Dec 14, 2010
Last updated
Jan 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Michael Wayne, MDNPI 1629177035
Title
Managing Member
Phone
(248) 348-8700

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
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

422 N Center St
Northville, MI 48167-1224

Mailing address

PO Box 27420
Belfast, ME 04915-2026
Phone (405) 682-3303

National Provider Directory

National Provider Directory

Locations

422 N Center St
Ste A
Northville, MI 48167
Phone (248) 348-1131

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

39475 Lewis Dr
Ste 110
Novi, MI 48377
Phone (248) 471-0675

39475 Lewis Dr
Ste 200
Novi, MI 48377
Phone (248) 471-0675

12660 10 Mile Rd
Ste 101
South Lyon, MI 48178
Phone (248) 449-7156

12660 10 Mile Rd
Ste A
South Lyon, MI 48178
Phone (248) 587-1132

Practitioners & affiliated clinicians

Practitioners 74

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.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1821391848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27420",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049152026",
            "telephone_number": "405-682-3303",
            "fax_number": "405-384-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 N CENTER ST",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671224",
            "telephone_number": "248-348-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "WAYNE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "248-348-8700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.