Genesis MD, PLLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

GENESIS MD, PLLC

Practice address

8560 N Silvery LN Ste 101
Dearborn Heights, MI 48127-4516

Phone

(313) 581-3255

NPI assigned

Mar 26, 2019

Organization subpart

No

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

Authorized official

Name

Edrick Ferguson, MD

Title

Owner

Phone

(313) 581-3255

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1982165619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8560 N SILVERY LN STE 202",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274515",
            "telephone_number": "313-581-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8560 N SILVERY LN STE 101",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274516",
            "telephone_number": "313-581-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "EDRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-581-3255",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latavia Garrett
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• Dania Gelan
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• Gentle Care Dental
• Genuine Home Care
• Get Well Urgent Care Dearborn Heights PLC
• Ghaleb F Hatem, MD, PC
• Reem Ghaleb

• Interventional Pain Medicine Physician in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Interventional Pain Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.