NPIMap

Organization Active NPI

Worcester Home

  • Health Maintenance Organization
  • Farmington Hills, MI
National Provider Identifier
1861720609
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
716877 Issued in MI
Legal business name
WORCESTER HOME
Practice address
24922 Independence Dr Apt 6208
Farmington Hills, MI 48335-1744
Phone
(248) 996-0604
NPI assigned
Dec 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Authorized official

Name
Ms. Marylin Brown
Title
Vice President
Phone
(248) 996-0604

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 716877 MI Primary
Preferred Provider Organization 305R00000X 716877 MI

Addresses

Primary practice location

24922 Independence Dr Apt 6208
Farmington Hills, MI 48335-1744

Mailing address

24922 Independence Dr Apt 6208
Farmington Hills, MI 48335-1744
Phone (248) 996-0604

Other identifiers 1

IdentifierTypeStateIssuer
716877MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1861720609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24922 INDEPENDENCE DR APT 6208",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483351744",
            "telephone_number": "248-996-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24922 INDEPENDENCE DR APT 6208",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483351744",
            "telephone_number": "248-996-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORCESTER HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-04",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MARYLIN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "248-996-0604",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MI",
            "license": "716877",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MI",
            "license": "716877",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "716877",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.