NPIMap

Organization Active NPI

The Wellness Plan Medical Centers

Doing business as The Wellness Plan

  • Clinic/Center
  • Oak Park, MI
National Provider Identifier
1982863478
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
THE WELLNESS PLAN MEDICAL CENTERS
Doing business as
The Wellness Plan
The Wellness Plan Medical Centers
Practice address
21040 Greenfield Rd
Oak Park, MI 48237-3025
Phone
(248) 967-6500
Fax
(248) 967-6528
NPI assigned
Jun 9, 2008
Last updated
Aug 13, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
THE WELLNESS PLAN MEDICAL CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Authorized official

Name
Mr. Anthony V. King
Title
Ceo and Exec. Dir.
Phone
(313) 202-8550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

21040 Greenfield Rd
Oak Park, MI 48237-3025

Mailing address

7700 2ND Ave
Detroit, MI 48202-2477
Phone (313) 202-8660

Other names 2

  • The Wellness Plan Doing business as
  • The Wellness Plan Medical Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080619000341 MI Part A Provider - Federally Qualified Health Center (FQHC) 1052380201 1 other NPI on this enrollment
Practice locations: Oak Park, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982863478. Details of each certification follow.

Federally qualified health center certification: CCN 231933

Legal name
THE WELLNESS PLAN MEDICAL CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 6, 2008
Last certification
Aug 6, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 14, 1972 in MI
Enrollment address
21040 Greenfield Rd
Oak Park, MI 48237-3025

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Health SV10 organizations share this tax ID, including this one
Part of
Comprehensive Health SV

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Anthony V King Individual Corporate OfficerCeo and Executive Director Feb 12, 2007 100%
W-2 Managing Employee Feb 12, 2007
Daniell L Jones Individual Corporate Director Oct 18, 2010
Margaret L Betts Individual Corporate Director Dec 7, 2005
Mahasin N. Pierce Individual Corporate Director Jun 12, 2013
Cassandra Willis-Abner Individual Corporate Director Jan 9, 2013
Anita Moncrease Individual Corporate Director Dec 7, 2005
Adrian Lewis Individual Corporate Director Jan 9, 2013
Betty Shelton Individual Corporate DirectorChief Administrative Officer May 1, 2016
W-2 Managing EmployeeChief Administrative Officer May 1, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Wellness Plan Medical Center-PontiacPontiac, MI, CCN 231127 Federally qualified health center Operational/Managerial Control (100%) Jul 7, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1982863478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 2ND AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022477",
            "telephone_number": "313-202-8660",
            "fax_number": "313-202-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21040 GREENFIELD RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373025",
            "telephone_number": "248-967-6500",
            "fax_number": "248-967-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS PLAN MEDICAL CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE WELLNESS PLAN MEDICAL CENTERS",
        "enumeration_date": "2008-06-09",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "CEO AND EXEC. DIR.",
        "authorized_official_telephone_number": "313-202-8550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wellness Plan",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Wellness Plan Medical Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Wellness Plan Medical Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Park, MI

Sources for this page

Verify at the official NPI Registry.