NPIMap

Organization Active NPI

Pedicare Pediatric Clinic PC

  • Primary Care Clinic/Center
  • Westland, MI
National Provider Identifier
1881700128
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
VT 006757 Issued in MI
Legal business name
PEDICARE PEDIATRIC CLINIC PC
Practice address
35240 Nankin Blvd
Ste # 401
Westland, MI 48185-7218
Phone
(734) 427-3636
Fax
(734) 427-1483
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Verna Jean Turkish, DONPI 1356433841
Title
Owner
Phone
(734) 427-4067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X VT 006757 MI Primary

Addresses

Primary practice location

35240 Nankin Blvd
Ste # 401
Westland, MI 48185-7218

Mailing address

35240 Nankin Blvd
Ste # 401
Westland, MI 48185-7218
Phone (734) 427-3636

Other identifiers 3

IdentifierTypeStateIssuer
383159597OtherMIFEDERAL TAX ID
3025602-11MedicaidMI
VT 006757OtherMILICENSE NO.

National Provider Directory

National Provider Directory
Tax ID family
Pedi Care Pediatric Clinic PC2 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

35240 Nankin Blvd
Ste 401
Westland, MI 48185
Phone (734) 427-3636

Practitioners & affiliated clinicians

Practitioners 2

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": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1881700128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35240 NANKIN BLVD",
            "address_2": "STE # 401",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481857218",
            "telephone_number": "734-427-3636",
            "fax_number": "734-427-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35240 NANKIN BLVD",
            "address_2": "STE # 401",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481857218",
            "telephone_number": "734-427-3636",
            "fax_number": "734-427-1483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDICARE PEDIATRIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "TURKISH",
        "authorized_official_first_name": "VERNA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-427-4067",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "VT 006757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "383159597",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025602-11",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO.",
            "identifier": "VT 006757",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.