DETROIT WAYNE COUNTY HEALTH AUTHORITY
NPI 1962733089
Clinic/Center - Primary Care in Detroit, MI

Active since January 29, 2010
10809 MACK AVE, DETROIT, MI 48214(313) 824-1000(313) 824-9000 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 19, 2026, Dec 1, 2025, Mar 17, 2016 (3 updates tracked since 2016).

About Detroit Wayne County Health Authority NPPES

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

DETROIT WAYNE COUNTY HEALTH AUTHORITY (NPI 1962733089) is a healthcare organization registered as a primary care in Detroit, Michigan and active in the NPI registry since January 2010. The organization maintains 3 additional practice locations and lists Loretta Bush, Ceo, as its authorized official.

NPPES Registry Identity

NPI1962733089
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameDETROIT WAYNE COUNTY HEALTH AUTHORITY
Location Address10809 MACK AVEDetroit, MI 48214-2119
Mailing Address3031 W Grand BlvdDetroit, MI 48202-3046 · (313) 824-1000 · Fax (313) 824-9000
Fax(313) 824-9000
Organization SubpartNo
Authorized OfficialLoretta BushCeo · (313) 871-3751
Enumeration DateJanuary 29, 2010
Last NPPES UpdateMay 19, 20263 updates tracked since enumeration
NPPES CertifiedMay 19, 2026
✔ NPI 1962733089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedPublic Health or WelfareTaxonomy 251K00000X · License 251K00000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
10809 MACK AVE, Detroit, MI 48214

Secondary Practice Locations 3

Location 127777 Lahser Rd Ste 200Southfield, MI 48034-4751 · Phone (313) 824-1000 · Fax (248) 945-3498
Location 223077 Greenfield RdSouthfield, MI 48075-3709 · Phone (313) 824-1000 · Fax (248) 569-9151
Location 312121 Broadstreet AveDetroit, MI 48204-1550 · Phone (313) 824-1000 · Fax (313) 931-8656

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Detroit Wayne County Health Authority is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Detroit Wayne County Health Authority, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (9)

Registered Dietitian or Nutrition Professional
NPI 1114544426
10809 MACK AVE
Detroit, MI 48214
(313) 824-1000
Same address
Family Practice
NPI 1093129520
10809 MACK AVE
Detroit, MI 48214
(313) 824-1000
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1730390832
10809 MACK AVE
Detroit, MI 48214
(313) 824-1000
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1588248280
3031 W GRAND BLVD STE 600
Detroit, MI 48202
(313) 871-3751
✔ PECOS✔ Accepts Medicare4.8 mi
Psychiatry
NPI 1366520470
17141 RYAN RD 4321 E. MCNICHOLS
Detroit, MI 48212
(313) 369-1717
✔ PECOS✔ Accepts Medicare5.0 mi
Nurse Practitioner
NPI 1003519885
12121 BROADSTREET AVE
Detroit, MI 48204
(313) 824-1000
✔ PECOS✔ Accepts Medicare7.8 mi
Nurse Practitioner
NPI 1497476006
23077 GREENFIELD RD STE 200
Southfield, MI 48075
(313) 824-1000
✔ PECOS13 mi
Mental Health Counselor
NPI 1538546775
24293 TELEGRAPH RD SUITE 218
Southfield, MI 48033
(313) 444-7992
✔ PECOS✔ Accepts Medicare16 mi
Pediatric Medicine
NPI 1801858733
1600 S CANTON CENTER RD SUITE 200
Canton, MI 48188
(734) 398-8675
✔ PECOS26 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Detroit Wayne County Health Authority's NPI number?

The NPI number for Detroit Wayne County Health Authority is 1962733089. It was assigned to this organization in the NPPES registry on January 29, 2010.

Where is Detroit Wayne County Health Authority located?

Detroit Wayne County Health Authority is located at 10809 Mack Ave, Detroit, MI 48214. The listed phone number is (313) 824-1000.

What is Detroit Wayne County Health Authority's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Detroit Wayne County Health Authority enrolled in Medicare?

Yes. Detroit Wayne County Health Authority is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Detroit Wayne County Health Authority?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 6 Medicare specialties reassign their Medicare billing to Detroit Wayne County Health Authority. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (3), Nurse Practitioner (2) and Mental Health Counselor (1). Of these, 3 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Detroit Wayne County Health Authority 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 Detroit Wayne County Health Authority 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 Detroit Wayne County Health Authority was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.