Organization Active NPI

Mercy Medical Group

  • Nurse Practitioner
  • Rochester Hills, MI
National Provider Identifier
1912045774
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MERCY MEDICAL GROUP
Practice address
1812 S Rochester Rd
Rochester Hills, MI 48307-3532
Phone
(248) 656-3515
Fax
(248) 656-7748
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jack Weiner
Title
Ceo
Phone
(248) 858-3140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

1812 S Rochester Rd
Rochester Hills, MI 48307-3532

Mailing address

44428 Woodward Ave
Lower Level
Pontiac, MI 48341-5009
Phone (248) 858-6144

National Provider Directory

National Provider Directory
Tax ID family
Mercy Medical Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

44428 Woodward Ave
Lowr
Pontiac, MI 48341

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912045774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44428 WOODWARD AVE",
            "address_2": "LOWER LEVEL",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415009",
            "telephone_number": "248-858-6144",
            "fax_number": "248-858-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 S ROCHESTER RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073532",
            "telephone_number": "248-656-3515",
            "fax_number": "248-656-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-858-3140"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.