Family Medical Center of Michigan, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Monroe, MI
NPI 1922397447 · NPPES record last updated Oct 9, 2012
Key facts
- NPI
- 1922397447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- FAMILY MEDICAL CENTER OF MICHIGAN, INC
- Practice address
- 905 N Macomb St
Ste 3
Monroe, MI 48162-3076 - Phone
- (734) 240-4851
- Fax
- (734) 240-4853
- NPI assigned
- Apr 5, 2011
- Organization subpart
- No
Authorized official
- Name
- Mr. Ed Larkins
- Title
- Executive Director
- Phone
- (734) 850-6914
Other NPIs on the same Medicare enrollment 8
Practitioners 3
-
Shawn R Gerrity, PA-C
-
Mark Thomas Koehl, M.D.
-
Regina South, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070910000059 | MI | Part B Supplier - Clinic/Group Practice | 2769575653 |
Receives reassigned benefits from 35 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Adrian, MI; Carleton, MI; Monroe, MI; Temperance, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | MI | Yes |
Addresses
Primary practice location
905 N Macomb St
Ste 3
Monroe, MI 48162-3076
Mailing address
8765 Lewis Ave
Temperance, MI 48182-9583
Phone (734) 847-3802
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02214 | Other | PARAMOUNT HEALTH CARE |
Other providers in Monroe, MI
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan, Inc
- Family Medical Center of Michigan,Inc
- Family Medical Center of Michigan,Inc
- Family Medical Center of Michigan,Inc
- Family Medical Center of Michigan,Inc
- Family Medical Center of Michigan,Inc
All providers in Monroe, MI · Federally Qualified Health Center (FQHC) in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.