Organization Active NPI

Fenix Health Mi PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wyoming, MI
National Provider Identifier
1861163065
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
FENIX HEALTH MI PLLC
Practice address
1428 44TH St SW Ste a
Wyoming, MI 49509-4312
Phone
(303) 250-2285
Fax
(888) 399-6476
NPI assigned
Sep 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Mark Mikula, MD
Title
MD
Phone
(303) 250-2285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X Primary

Addresses

Primary practice location

1428 44TH St SW Ste a
Wyoming, MI 49509-4312

Mailing address

1428 44TH St SW Ste a
Wyoming, MI 49509-4312
Phone (303) 250-2285

National Provider Directory

National Provider Directory

Locations

1428 44th St SW
Ste A
Wyoming, MI 49509
Phone (303) 250-2285

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1861163065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 44TH ST SW STE A",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094312",
            "telephone_number": "303-250-2285",
            "fax_number": "888-399-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 44TH ST SW STE A",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094312",
            "telephone_number": "303-250-2285",
            "fax_number": "888-399-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENIX HEALTH MI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "MIKULA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "303-250-2285",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.