Individual provider Active NPI

Edith Espiller Lara, CHW

  • Community Health Worker
  • Monroe, MI
National Provider Identifier
1104638907
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
135359129 Issued in MI
Practice address
2456 10TH St
Monroe, MI 48162-4333
Phone
(734) 265-6480
NPI assigned
Jan 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 135359129 MI Primary

Addresses

Primary practice location

2456 10TH St
Monroe, MI 48162-4333

Mailing address

2456 10TH St
Monroe, MI 48162-4333
Phone (734) 265-6480

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
135359129MIMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1104638907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 10TH ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624333",
            "telephone_number": "734-265-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 10TH ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624333",
            "telephone_number": "734-265-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPILLER LARA",
        "first_name": "EDITH",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": "135359129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.