Active NPI
Robert Edison Farrell Jr.
- Case Manager/Care Coordinator
- Port Huron, MI
National Provider Identifier
1033745666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 3111 Electric Ave
Port Huron, MI 48060-8127 - Phone
- (810) 985-8900
- NPI assigned
- Mar 15, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
3111 Electric Ave
Port Huron, MI 48060-8127
Mailing address
3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 985-8900
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": "1584230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584230400000",
"number": "1033745666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3111 ELECTRIC AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480608127",
"telephone_number": "810-985-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 ELECTRIC AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480608127",
"telephone_number": "810-985-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "ROBERT",
"middle_name": "EDISON",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-15",
"last_updated": "2020-03-15",
"certification_date": "2020-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Huron, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.