Triple T Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301068024 Issued in MI

Legal business name

TRIPLE T MEDICAL PC

Practice address

17187 Schaefer Hwy
Detroit, MI 48235-4132

Phone

(313) 342-9255

Fax

(313) 342-8489

NPI assigned

Dec 10, 2009

Organization subpart

No

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

Authorized official

Name

Leonard Ellison Jr., MD

Title

Owner

Phone

(313) 342-9255

Specialties & licenses 5

Addresses

Other identifiers 3

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1942539598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17187 SCHAEFER HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482354132",
            "telephone_number": "313-342-9255",
            "fax_number": "313-342-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17187 SCHAEFER HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482354132",
            "telephone_number": "313-342-9255",
            "fax_number": "313-342-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPLE T MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2010-06-01",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-342-9255",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301058406",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301068024",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301053315",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301066816",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301053315",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NP GROUP NUMBER",
            "identifier": "500H258510",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "700H258460",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942539598",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trinity Medical Clinic
• Trinity Mihp
• Nishita Tripathi, MD
• Martina Tripcovici, M.D.
• Triple C's Care, Inc
• Latasha Starr Tripp
• Trisource Group Inc
• Kirtikumar M Trivedi, HT
• Peter Sciarretta Troccoli, DPM
• Suzanne Trojanowski

• Internal Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.