Organization Active NPI

Michigan Institute for Health Enhancement

  • Nutrition Education Nutritionist
  • Rochester, MI
National Provider Identifier
1861489502
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
850328 Issued in IL
Legal business name
MICHIGAN INSTITUTE FOR HEALTH ENHANCEMENT
Practice address
4986 N. Adams Rd.
Suite D
Rochester, MI 48306-1416
Phone
(248) 475-4880
Fax
(248) 475-5777
NPI assigned
Sep 27, 2005
Last updated
Aug 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Authorized official

Name
Dr. Algirdas Antanas Juocys, D.O.
Title
Chief Medical Officer
Phone
(248) 475-4702

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X 850328 IL Primary
Nutrition Education Nutritionist 133NN1002X NU

Addresses

Primary practice location

4986 N. Adams Rd.
Suite D
Rochester, MI 48306-1416

Mailing address

4986 N. Adams Rd.
Suite D
Rochester, MI 48306-1416
Phone (248) 475-4880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071031000026 MI Part B Supplier - Clinic/Group Practice 7719074293 Receives reassigned benefits from 2 practitioners
Practice locations: Rochester, MI
O20180420001812 MI MDPP Supplier - in-Person MDPP Supplier 7719074293 Practice locations: Rochester, MI

National Provider Directory

National Provider Directory

Locations

611 Cascade West Pkwy SE
Grand Rapids, MI 49546
Phone (248) 475-4860

4986 N Adams Rd
Ste E
Rochester Hills, MI 48306
Phone (248) 475-4701

30061 Schoenherr Rd
Warren, MI 48088
Phone (248) 475-4728

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1861489502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4986 N. ADAMS RD.",
            "address_2": "SUITE D",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483061416",
            "telephone_number": "248-475-4880",
            "fax_number": "248-475-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4986 N. ADAMS RD.",
            "address_2": "SUITE D",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483061416",
            "telephone_number": "248-475-4880",
            "fax_number": "248-475-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN INSTITUTE FOR HEALTH ENHANCEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "JUOCYS",
        "authorized_official_first_name": "ALGIRDAS",
        "authorized_official_middle_name": "ANTANAS",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "248-475-4702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "IL",
            "license": "850328",
            "primary": true
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.