NPIMap

Organization Active NPI

Minuteclinic Diagnostic of Michigan PC

  • Family Nurse Practitioner
  • Northville, MI
National Provider Identifier
1902848617
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MINUTECLINIC DIAGNOSTIC OF MICHIGAN PC
Practice address
39350 9 Mile Rd
Northville, MI 48167-9164
Phone
(866) 389-2727
Fax
(401) 406-3539
NPI assigned
Jun 10, 2006
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Deborah Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

39350 9 Mile Rd
Northville, MI 48167-9164

Mailing address

PO Box 772
Minuteclinic Credentialing
Woonsocket, RI 02895-0784
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060912000584 MI Part B Supplier - Clinic/Group Practice 9133123755 Receives reassigned benefits from 74 practitioners
Practice locations: Waterford, MI; Walled Lake, MI; Shelby Township, MI; Grosse Pointe, MI; Rochester Hills, MI; Northville, MI; Macomb, MI; Ann Arbor, MI…

National Provider Directory

National Provider Directory

Locations

33920 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 725-3900

200 Renaissance Ctr
Detroit, MI 48243
Phone (313) 567-3523

33021 Garfield Rd
Fraser, MI 48026
Phone (586) 293-5012

5529 Sashabaw Rd
Independence, MI 48346
Phone (248) 620-6663

720 General Motors Rd
Milford, MI 48381
Phone (248) 684-1775

46960 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 726-9220

22421 Pontiac Trl
South Lyon, MI 48178
Phone (248) 437-8131

2045 South Blvd W
Troy, MI 48098
Phone (248) 879-8322

2025 Fort St
Wyandotte, MI 48192
Phone (734) 283-9640

Practitioners & affiliated clinicians

Practitioners 77

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1902848617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "address_2": "MINUTECLINIC CREDENTIALING",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39350 9 MILE RD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481679164",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC OF MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.