NPIMap

Organization Active NPI

Packard Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ann Arbor, MI
National Provider Identifier
1922491760
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PACKARD HEALTH, INC.
Practice address
3174 Packard St
Ann Arbor, MI 48108-1947
Phone
(734) 971-1073
NPI assigned
Mar 17, 2015
Last updated
Dec 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Authorized official

Name
Todd Montrief, CPA
Title
Cfo
Phone
(734) 926-4935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3174 Packard St
Ann Arbor, MI 48108-1947

Mailing address

5200 Venture Dr
Ann Arbor, MI 48108-9561
Phone (734) 926-4935

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1922491760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VENTURE DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089561",
            "telephone_number": "734-926-4935",
            "fax_number": "734-773-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3174 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081947",
            "telephone_number": "734-971-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACKARD HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "MONTRIEF",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "734-926-4935",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.