Individual provider Active NPI

Michael John Fite

  • General Practice Physician
  • Clinton Township, MI
National Provider Identifier
1871988469
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
7246 Issued in OK
Practice address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone
(586) 263-2952
NPI assigned
Apr 1, 2015
Last updated
Aug 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 5101021945 MI
General Practice Physician 208D00000X 7246 OK Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Mailing address

6220 Plum Thicket Rd
Oklahoma City, OK 73162-3423
Phone (405) 323-1729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118000650 OK Practitioner - General Practice 0244529386 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101021945MIMDInternal Medicine Physician
7246OKMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC General Practice CurrentSince Sep 4, 2024 Accepting new patients

Locations

10601 S Western Ave
Ste 100
Oklahoma City, OK 73170

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1871988469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 PLUM THICKET RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731623423",
            "telephone_number": "405-323-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITE",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101021945",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OK",
            "license": "7246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.