Individual provider Active NPI

Marquita Daniel, BCHHP

  • Prosthetics Case Management
  • Munster, IN
National Provider Identifier
1073135729
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
1630 45TH St Ste B101
Munster, IN 46321-3963
Phone
(219) 595-0566
NPI assigned
May 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Nutrition Education Nutritionist 133NN1002X
Health & Wellness Coach 171400000X
Prosthetics Case Management 1744P3200X Primary

Addresses

Primary practice location

1630 45TH St Ste B101
Munster, IN 46321-3963

Mailing address

1630 45TH St Ste B101
Munster, IN 46321-3963
Phone (219) 595-0566

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@mdtrichology.com

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

Practice roles

OrganizationSpecialtyStatusNew patients
MD Trichology LLC Nutrition, Education CurrentSince Jul 31, 2023 Accepting new patients

Locations

1630 45th St
Ste 101B
Munster, IN 46321
Phone (219) 595-0566

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1073135729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 45TH ST STE B101",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213963",
            "telephone_number": "219-595-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 45TH ST STE B101",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213963",
            "telephone_number": "219-595-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "MARQUITA",
        "credential": "BCHHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@mdtrichology.com",
            "affiliation": "N",
            "address_1": "1630 45th St Ste B101",
            "city": "Munster",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463213963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.