Active NPI
Bria Latoya Johnson
- Contractor
- Ecorse, MI
National Provider Identifier
1013460690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 479 Visger Rd
Ecorse, MI 48229-1365 - Phone
- (313) 595-5496
- NPI assigned
- Jul 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
479 Visger Rd
Ecorse, MI 48229-1365
Mailing address
PO Box 1352
Lincoln Park, MI 48146-7152
Phone (313) 236-0880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1013460690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1352",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481467152",
"telephone_number": "313-236-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "479 VISGER RD",
"city": "ECORSE",
"state": "MI",
"postal_code": "482291365",
"telephone_number": "313-595-5496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BRIA",
"middle_name": "LATOYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-29",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ecorse, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.