Individual provider Active NPI

Donna S. Beal-Lloyd, FNP-BC

  • Primary Care Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1083966220
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704177424 Issued in MI
Practice address
1151 Taylor St
Detroit, MI 48202-1732
Phone
(313) 876-4828
NPI assigned
Oct 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704177424 MI
Primary Care Nurse Practitioner 363LP2300X 4704177424 MI Primary

Addresses

Primary practice location

1151 Taylor St
Detroit, MI 48202-1732

Mailing address

18254 Midway Ave
Southfield, MI 48075-7137
Phone (248) 569-3105

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704177424MIMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: dbeall@direct.dmc.org

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1083966220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18254 MIDWAY AVE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480757137",
            "telephone_number": "248-569-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 TAYLOR ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482021732",
            "telephone_number": "313-876-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAL-LLOYD",
        "first_name": "DONNA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704177424",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704177424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.