Organization Active NPI

Primary Care Home Services, Inc

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1871852533
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIMARY CARE HOME SERVICES, INC
Practice address
2990 W Grand Blvd
Suite 307
Detroit, MI 48202-3041
Phone
(313) 870-9260
Fax
(313) 870-9266
NPI assigned
May 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Authorized official

Name
Mrs. Laynette Goudy-Egger, NURSE PRACTITIONER
Title
Administrator
Phone
(313) 870-9260

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

2990 W Grand Blvd
Suite 307
Detroit, MI 48202-3041

Mailing address

2990 W Grand Blvd
Suite 307
Detroit, MI 48202-3041
Phone (313) 870-9260

National Provider Directory

National Provider Directory

Locations

23801 Gratiot Ave
Ste 204
Eastpointe, MI 48021
Phone (586) 777-3621

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1871852533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 W GRAND BLVD",
            "address_2": "SUITE 307",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023041",
            "telephone_number": "313-870-9260",
            "fax_number": "313-870-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 W GRAND BLVD",
            "address_2": "SUITE 307",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023041",
            "telephone_number": "313-870-9260",
            "fax_number": "313-870-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE HOME SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "GOUDY-EGGER",
        "authorized_official_first_name": "LAYNETTE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-870-9260",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.