NPIMap

Organization Active NPI

Downriver Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Southgate, MI
National Provider Identifier
1861789083
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
4301057471 Issued in MI
Legal business name
DOWNRIVER URGENT CARE PLLC
Practice address
15830 Fort St
Suite One
Southgate, MI 48195-1367
Phone
(734) 282-5444
Fax
(734) 282-4899
NPI assigned
Jul 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Authorized official

Name
Dr. Mohamad Al-Jarrah, M.D.
Title
President
Phone
(734) 282-5444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 4301057471 MI Primary

Addresses

Primary practice location

15830 Fort St
Suite One
Southgate, MI 48195-1367

Mailing address

15830 Fort St
Suite One
Southgate, MI 48195-1367
Phone (734) 282-5444

Other identifiers 2

IdentifierTypeStateIssuer
4627560MedicaidMI
4627506MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Downriver Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15830 Fort St
Ste 1
Southgate, MI 48195
Phone (734) 282-5444

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1861789083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15830 FORT ST",
            "address_2": "SUITE ONE",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951367",
            "telephone_number": "734-282-5444",
            "fax_number": "734-282-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15830 FORT ST",
            "address_2": "SUITE ONE",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951367",
            "telephone_number": "734-282-5444",
            "fax_number": "734-282-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNRIVER URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "AL-JARRAH",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-282-5444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MI",
            "license": "4301057471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4627560",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4627506",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.