Individual provider Active NPI

Fatoumata Sawadogo

  • Licensed Practical Nurse
  • Redford, MI
National Provider Identifier
1043692361
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703114681 Issued in MI
Practice address
8983 Rockland
Redford, MI 48239-1832
Phone
(313) 948-0922
NPI assigned
Jun 23, 2015
Last updated
Jun 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703114681 MI Primary

Addresses

Primary practice location

8983 Rockland
Redford, MI 48239-1832

Mailing address

8983 Rockland
Redford, MI 48239-1832
Phone (313) 948-0922

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

State licenses

LicenseStateTypeSpecialty
4703114681MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1043692361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8983 ROCKLAND",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391832",
            "telephone_number": "313-948-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8983 ROCKLAND",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391832",
            "telephone_number": "313-948-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWADOGO",
        "first_name": "FATOUMATA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703114681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.