Organization Active NPI

Dr. Marcia E. Kling, MD, PC

  • Family Medicine Physician
  • Shelby Township, MI
National Provider Identifier
1912194622
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MK4301060329 Issued in MI
Legal business name
DR. MARCIA E. KLING, MD, PC
Practice address
47733 Van Dyke Ave
Shelby Township, MI 48317-3372
Phone
(586) 254-2534
Fax
(586) 254-3889
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Dr. Marcia Elizabeth Kling, M.D.NPI 1134130834
Title
President/Owner
Phone
(586) 254-2534

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MK4301060329 MI Primary

Addresses

Primary practice location

47733 Van Dyke Ave
Shelby Township, MI 48317-3372

Mailing address

47733 Van Dyke Ave
Shelby Township, MI 48317-3372
Phone (586) 254-2534

Other identifiers 1

IdentifierTypeStateIssuer
4439533MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080117000250 MI Part B Supplier - Clinic/Group Practice 3577644400 Receives reassigned benefits from 1 practitioner
Practice locations: Shelby Township, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1001510Marcia E Kling, MD, PC47733 Van Dyke, Shelby Township, MI 48317Certificate of waiverJul 11, 2028

National Provider Directory

National Provider Directory

Locations

47733 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 254-2534

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": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1912194622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47733 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483173372",
            "telephone_number": "586-254-2534",
            "fax_number": "586-254-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47733 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483173372",
            "telephone_number": "586-254-2534",
            "fax_number": "586-254-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARCIA E. KLING, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "KLING",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "586-254-2534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "MK4301060329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4439533",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.