Jared M Landry, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

47404217162 Issued in MI

Practice address

6211 Taylor Dr
Flint, MI 48507-4665

Phone

(810) 237-0799

Fax

(517) 676-5460

NPI assigned

Jun 20, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1083064117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 OKEMOS ST",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541226",
            "telephone_number": "517-833-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 TAYLOR DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485074665",
            "telephone_number": "810-237-0799",
            "fax_number": "517-676-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "JARED",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502001615",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "47404217162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy L Lancaster
• Stephen Roy Lancaster, MA LLPC,QMRP
• Aleksis Nichole Landers
• Nichole Leann Landers, PRC
• Landis Vision Center LLC
• Erica Lane
• Frederick Lane
• Laura Suzanne Lane, OD
• Shavon Lane, BSHS, CMHP, QMHP, QI
• Vincent Lang, BA

• Registered Nurse in Flint, MI
• Providers in Flint, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.

Verify at the official NPI Registry.