PREVENTIVE CARE CENTER PLC (NPI# 1700214756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700214756 |
| Entity Type | Organization |
| Organization Name | PREVENTIVE CARE CENTER PLC |
| Practice Address |
2284 S Ballenger Hwy Ste H Flint MI 48503-3446 |
| Practice Telephone | 8102335211 |
| Practice Fax Number | 8102335740 |
| Mailing Telephone | 8102335211 |
| Mailing Fax Number | 8102335740 |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |
| Authorized Official Name | SETH R BERNARD (MEMBER) |
| Authorized Official Telephone | 8102335211 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
2284 S BALLENGER HWY STE H |
| City | FLINT |
| State | MI |
| Zip Code | 48503-3446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992774194 | Janice Kay Shimoda | General Practice | 2284 S Ballenger Hwy, Suite H, Flint, MI 48503-4653 | 2006-03-17 |
| 1558993139 | Hailee Strong | Behavior Technician | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2020-02-11 |
| 1083258784 | Larissa Cottrell | Behavior Technician | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2019-11-05 |
| 1649813775 | Omar Mohamed-f Elnour | Technician, Other | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2019-10-22 |
| 1386287670 | Najla Collins | Behavior Technician | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2019-10-20 |
| 1417599705 | Saundra Marie Harris | Behavior Technician | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2019-10-08 |
| 1558913624 | Elonda Clemons | Technician, Health Information | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2019-07-09 |
| 1720640386 | Nadia M Johnson | Behavior Technician | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2019-07-03 |
| 1013579879 | Chester Watson IIi | Technician, Other | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2019-07-02 |
| 1972162287 | Zakory Mitchel Dippold | Technician | 2284 S Ballenger Hwy, Flint, MI 48503-3446 | 2019-06-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457971640 | Flint Odyssey House Inc. | Community/Behavioral Health | 1219 Martin Luther King Avenue, Flint, MI 48503 | 2020-04-17 |
| 1891265476 | Mary Margaret Woodruff | Health Educator | 411 E. Third St Suite 2, Flint, MI 48503 | 2018-11-27 |
| 1669942223 | Donna Jean Phelps | Behavior Technician | 2284 S Ballenger Highway, Flint, MI 48503 | 2018-11-27 |
| 1588150601 | Dayonna Scott | Social Worker | Hope Network, 2830 Corunna Rd, Flint, MI 48503 | 2018-07-02 |
| 1801388020 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2284 S Ballenger Hwy Ste F, Flint, MI 48503 | 2018-06-04 |
| 1134610504 | Swathi Gorle | Student in an Organized Health Care Education/Training Program | Hurley Medical Center, 1 Hurley Plaza, Flint, MI 48503 | 2018-05-22 |
| 1881128049 | Kara Garr | Registered Nurse | 805 Tuuri Pl, Flint, MI 48503 | 2017-04-14 |
| 1518405638 | Thomasinia Terrell | Peer Specialist | 422 W Fourth Ave, Flint, MI 48503 | 2017-02-09 |
| 1790231041 | Roslyn Boyce | Technician, Other | 2213 E. Court Street, Flint, MI 48503 | 2016-08-28 |
| 1689120818 | Yasmine Elhefnawy | Student in an Organized Health Care Education/Training Program | One Hurley Plaza 3d West, Flint, MI 48503 | 2016-08-28 |
| Find all providers in zip 48503 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861990855 | Xpress Care Pllc | General Practice | 3507 Sunset Dr, Flint, MI 48503-2365 | 2018-01-25 |
| 1609293901 | Amir Al-dabagh | General Practice | 401 South Ballenger Hwy Flint, Mi 48532, Flint, MI 48532 | 2014-03-25 |
| 1053664672 | Claude W. Hall M.d. P.C. | General Practice | 2442 E Maple Ave, Suite 300, Flint, MI 48507-4462 | 2012-10-19 |
| 1730361361 | Awad A Aziem | General Practice | 4250 North Saginaw St, Suite A, Flint, MI 48505-2664 | 2007-12-05 |
| 1003002429 | Hurley Pho of Mid - Michigan | General Practice | 701 W 8th Ave, Flint, MI 48503-1261 | 2007-09-19 |
| 1144429762 | John J Hoban | General Practice | G5067 West Bristol Rd, Flint, MI 48507-2924 | 2007-07-13 |
| 1992774194 | Janice Kay Shimoda | General Practice | 2284 S Ballenger Hwy, Suite H, Flint, MI 48503-4653 | 2006-03-17 |
| 1487022489 | John Baistad Dolven | General Practice | 3441 Lapeer Rd, Flint, MI 48503 | 2015-09-08 |
| 1740622380 | Flint Wellness & Diagnostic Center Pllc | General Practice | 1134 S Linden Rd, Suite 8, Flint, MI 48532-3455 | 2013-07-24 |
| 1669711727 | Ashley Mae Walker | General Practice | 1 Hurley Plz, Flint, MI 48503 | 2013-02-11 |
| Find all providers in FLINT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.