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ACADIAN SUPREME HEALTH SERVICES
NPI 1871108217
Family Medicine in Southgate, MI

Active since September 12, 2020CLIA 23D2200119 · Waiver
12866 FORT ST, SOUTHGATE, MI 48195(313) 930-0258 Get Directions Write a Review

NPPES record last updated: September 12, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Acadian Supreme Health Services NPPES

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

ACADIAN SUPREME HEALTH SERVICES (NPI 1871108217) is a healthcare organization registered as a family medicine in Southgate, Michigan and active in the NPI registry since September 2020. The organization holds a CLIA Waiver certificate valid through November 12, 2026 and lists Ingrid N. Lewis, Authorized Official/fnp, as its authorized official.

NPPES Registry Identity

NPI1871108217
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameACADIAN SUPREME HEALTH SERVICES
Location Address12866 FORT STSouthgate, MI 48195-1060
Mailing Address20831 Ridgemont RdHarper Woods, MI 48225-1137 · (313) 930-0258
Phone(313) 930-0258
Organization SubpartNo
Authorized OfficialIngrid N. LewisAuthorized Official/fnp · (313) 930-0258
Enumeration DateSeptember 12, 2020
NPPES CertifiedSeptember 12, 2020
✔ NPI 1871108217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
12866 FORT ST, Southgate, MI 48195
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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 23D2200119

Acadian Supreme Health Services · Southgate, MI
Active · expires Nov 12, 2026
CLIA Number23D2200119
Laboratory TypePhysician Office
Certificate Effective DateNovember 13, 2024
Certificate Expiration DateNovember 12, 2026
Laboratory DirectorEqdam Radhi
Laboratory Phone(734) 720-7920
Laboratory LocationAcadian Supreme Health Services12866 Fort Street, 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 8

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

MOHAMAD H DAKDOUK DR.
Pharmacist
12866 FORT ST
SOUTHGATE, MI 48195
Wayne County (734) 288-3588
ACCOLADE HEALTH LLC
Clinic/Center
12866 FORT ST
SOUTHGATE, MI 48195
Wayne County (734) 720-7920
AT HOME CARE, INC.
Home Health
12866 FORT ST
SOUTHGATE, MI 48195
Wayne County (734) 558-3151
KISHA MAIRE MURRY
Nurse Practitioner (Primary Care)
12866 FORT ST
SOUTHGATE, MI 48195
Wayne County (734) 720-7920
UNITY HOME CARE INC.
Home Health
12866 FORT ST
SOUTHGATE, MI 48195
Wayne County (734) 225-4422
MD ROYAL PHARMACY INC
Pharmacy (Community/Retail Pharmacy)
12866 FORT ST
SOUTHGATE, MI 48195
Wayne County (734) 288-3588
INGRID LEWIS FNP
Nurse Practitioner
12866 FORT ST
SOUTHGATE, MI 48195
Wayne County (734) 720-7920
SURMOUNTING LLC
Family Medicine
12866 FORT ST
SOUTHGATE, MI 48195
Wayne County (734) 720-7920

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 Acadian Supreme Health Services's NPI number?

The NPI number for Acadian Supreme Health Services is 1871108217. It was assigned to this organization in the NPPES registry on September 12, 2020.

Where is Acadian Supreme Health Services located?

Acadian Supreme Health Services is located at 12866 Fort St, Southgate, MI 48195. The listed phone number is (313) 930-0258.

What is Acadian Supreme Health Services's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Acadian Supreme Health Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2200119) is associated with this NPI, valid through November 12, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Acadian Supreme Health Services accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Acadian Supreme Health Services as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Acadian Supreme Health Services was last updated on September 12, 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.