Individual provider Active NPI

Faith Diane McLean, ATC

  • Student in an Organized Health Care Education/Training Program
  • Durham, NC
National Provider Identifier
1104283811
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
36460564 Issued in NC
Practice address
809 Hurley Rd
Durham, NC 27704-5321
Phone
(919) 323-5699
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 36460564 NC Primary

Addresses

Primary practice location

809 Hurley Rd
Durham, NC 27704-5321

Mailing address

809 Hurley Rd
Durham, NC 27704-5321
Phone (919) 323-5699

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
36460564NCMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1104283811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 HURLEY RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277045321",
            "telephone_number": "919-323-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 HURLEY RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277045321",
            "telephone_number": "919-323-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "FAITH",
        "middle_name": "DIANE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "36460564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

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