DRS. Detrick & Detrick Inc.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

032039822 Issued in OH

Legal business name

DRS. DETRICK & DETRICK INC.

Practice address

5757 Monclova Road
Suite 14
Maumee, OH 43537

Phone

(419) 893-3316

NPI assigned

Apr 19, 2007

Last updated

Apr 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cyndee J Detrick

Title

Office Manager

Phone

(419) 893-3316

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1114144300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 MONCLOVA ROAD",
            "address_2": "SUITE 14",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "43537",
            "telephone_number": "419-893-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 MONCLOVA ROAD",
            "address_2": "SUITE 14",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "43537",
            "telephone_number": "419-893-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. DETRICK & DETRICK INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "DETRICK",
        "authorized_official_first_name": "CYNDEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "419-893-3316"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "032039822",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "OH",
            "license": "RN113039",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CB3101",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Maumee, OH
• Providers in Maumee, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.