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FAMILY MEDICAL CENTER OF MI-SOUTHGATE
NPI 1407392970
Clinic/Center - Federally Qualified Health Center (FQHC) in Southgate, MI

Active since January 09, 2017CLIA 23D2124862 · Waiver
13101 ALLEN RD, SOUTHGATE, MI 48195(734) 654-2169(734) 654-2535 Get Directions Write a Review

NPPES record last updated: September 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 22, 2020, Feb 27, 2017, Feb 24, 2017 and 1 more (4 updates tracked since 2017).

About Family Medical Center Of Mi-southgate NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY MEDICAL CENTER OF MI-SOUTHGATE (NPI 1407392970) is a healthcare organization registered as a federally qualified health center (fqhc) in Southgate, Michigan and active in the NPI registry since January 2017. The organization holds a CLIA Waiver certificate valid through January 25, 2027 and lists Ed Larkins, Ceo, as its authorized official.

NPPES Registry Identity

NPI1407392970
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameFAMILY MEDICAL CENTER OF MICHIGAN,INC
Location Address13101 ALLEN RDSouthgate, MI 48195-2216
Mailing Address8765 Lewis AveTemperance, MI 48182-9583 · (734) 847-3802 · Fax (734) 850-0520
Phone(734) 654-2169
Fax(734) 654-2535
Organization SubpartNo
Authorized OfficialEd LarkinsCeo · (734) 850-6914
Enumeration DateJanuary 9, 2017
Last NPPES UpdateSeptember 22, 20204 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2020
✔ NPI 1407392970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in MI · H19CS02960
13101 ALLEN RD, Southgate, MI 48195
Open in Google Maps ↗

Other Names 1

Doing Business AsFamily Medical Center Of Mi-southgate

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2124862

Family Medical Center · Southgate, MI
Active · expires Jan 25, 2027
CLIA Number23D2124862
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJanuary 26, 2025
Certificate Expiration DateJanuary 25, 2027
Laboratory DirectorMarcia L. Patton
Laboratory Phone(734) 850-6902
Laboratory LocationFamily Medical Center13101 Allen Road Suite 300, Southgate, MI 48195
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LORI SUE MITCHELL RN
Registered Nurse
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7731
SHANNON BAYNAI
Social Worker (Clinical)
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7700
MISS RENEE GOLDSBY
Case Manager/Care Coordinator
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 486-3199
POONAM SHYAM MELWANI
Social Worker
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7705
MR. JAMES GERARD LIVINGSTON LLMSW
Social Worker (Clinical)
13101 ALLEN RD, SUITE 400
SOUTHGATE, MI 48195
Wayne County (734) 785-7705
VICKIE LYNN NOVELL LMSW
Social Worker (Clinical)
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7700
CLAUDETTE JEFFERSON LMSW
Social Worker (Clinical)
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7705
RICKY DAVIS QMHS-B
Case Manager/Care Coordinator
13101 ALLEN RD
SOUTHGATE, MI 48195
Wayne County (734) 785-7700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Medical Center Of Michigan,inc's NPI number?

The NPI number for Family Medical Center Of Michigan,inc is 1407392970. It was assigned to this organization in the NPPES registry on January 9, 2017. The provider is doing business as Family Medical Center Of Mi-Southgate.

Where is Family Medical Center Of Michigan,inc located?

Family Medical Center Of Michigan,inc is located at 13101 Allen Rd, Southgate, MI 48195. The listed phone number is (734) 654-2169.

What is Family Medical Center Of Michigan,inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Family Medical Center Of Michigan,inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2124862) is associated with this NPI, valid through January 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Family Medical Center Of Michigan,inc was last updated on September 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.