Individual provider Active NPI

Rickey Eugene Stoker, BACHELOR OF SCIENCE

  • Case Manager/Care Coordinator
  • Dearborn, MI
National Provider Identifier
1114271103
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1800 Grindley
Suite 3
Dearborn, MI 48124
Phone
(313) 277-1166
NPI assigned
Oct 30, 2012
Last updated
Oct 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

1800 Grindley
Suite 3
Dearborn, MI 48124

Mailing address

PO Box 5518
Detroit, MI 48205-0518

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

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1114271103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5518",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482050518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GRINDLEY",
            "address_2": "SUITE 3",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-277-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKER",
        "first_name": "RICKEY",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "BACHELOR OF SCIENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.