Professional Plaza Clinic Corporation

Primary specialty

Legal MedicineTaxonomy code 173000000X

Legal business name

PROFESSIONAL PLAZA CLINIC CORPORATION

Practice address

2395 W Grand Blvd
Detroit, MI 48208-1210

Phone

(313) 831-2442

Fax

(313) 831-2444

NPI assigned

Jun 13, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Andrea P McBride

Title

Ceo/President

Phone

(313) 218-2709

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joy Jones Darden, M.D.

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1033315361
  Medicare reassignment Care Compare group NPD
• Stanley Keith Frencher Sr., MD

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1659468379
  Medicare reassignment Care Compare group NPD
• Henri Godbold, M.D

  • Geriatric Medicine (Internal Medicine) Physician
  • Detroit, MI
  • NPI 1407012834
  Medicare reassignment NPD
• Charmaine Munn Hudson, NP

  • Family Nurse Practitioner
  • Detroit, MI
  • NPI 1780307082
  Medicare reassignment NPD
• Daniel Ea Thomas, DPM

  • Podiatrist
  • Grand Blanc, MI
  • NPI 1245338961
  Medicare reassignment NPD
• Kai Banks, PNP

  • Pediatric Nurse Practitioner
  • Southfield, MI
  • NPI 1649515578
  NPD (past)
• Ann Davis Garvin, CNM

  • Advanced Practice Midwife
  • Detroit, MI
  • NPI 1184808966
  NPD (past)
• Lisa Marie Randon, M.D.

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1316088644
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1992709331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081210",
            "telephone_number": "313-831-2442",
            "fax_number": "313-831-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081210",
            "telephone_number": "313-831-2442",
            "fax_number": "313-831-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PLAZA CLINIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "313-218-2709",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Care Initiatives, Inc.
• Professional Care Rehab LLC
• Professional Home Doctors
• Professional Medical Center PC
• Professional Patient Care PC
• Professional Sonocardiographic Imaging
• Progress Transitionalnonprofit Housing Corporation
• Progressive Care Home Health Services, LLC
• Progressive Human Services Inc.
• Progressive Therapy & Rehab Center, Inc.

• Legal Medicine in Detroit, MI
• Providers in Detroit, MI by specialty
• Legal Medicine in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.