Individual provider Active NPI

Maja Cerimagic, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • West Bloomfield, MI
National Provider Identifier
1033604533
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
4704260876 Issued in MI
Practice address
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone
(248) 325-2839
NPI assigned
Jun 27, 2018
Last updated
Jul 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 4704260876 MI Primary

Addresses

Primary practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Mailing address

995 N. Pontiac Trail
PO Box 377
Walled Lake, MI 48390-2257
Phone (734) 718-3734

Other practice location 1

1685 McCoy St
Commerce Township, MI 48390-2257
Phone (734) 718-3734

Other practice location 2

1685 McCoy St
Commerce Township, MI 48390-2257
Phone (734) 718-3734

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704260876MIMDLactation Consultant (Registered Nurse)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1033604533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 N. PONTIAC TRAIL",
            "address_2": "PO BOX 377",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483902257",
            "telephone_number": "734-718-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-325-2839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1685 McCoy St",
            "address_purpose": "LOCATION",
            "city": "Commerce Township",
            "state": "MI",
            "postal_code": "483902257",
            "country_code": "US",
            "telephone_number": "734-718-3734",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1685 McCoy St",
            "address_purpose": "LOCATION",
            "city": "Commerce Township",
            "state": "MI",
            "postal_code": "483902257",
            "country_code": "US",
            "telephone_number": "734-718-3734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERIMAGIC",
        "first_name": "MAJA",
        "name_prefix": "Mrs.",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MI",
            "license": "4704260876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.