Individual provider Active NPI

Johny Sebastian

  • Registered Nurse
  • Farmington Hills, MI
National Provider Identifier
1124562186
Registry record updated Dec 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704289322 Issued in MI
Practice address
38855 Hills Tech Dr
Farmington Hills, MI 48331-3421
Phone
(248) 745-4900
Fax
(248) 994-8005
NPI assigned
Dec 10, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704289322 MI Primary

Addresses

Primary practice location

38855 Hills Tech Dr
Farmington Hills, MI 48331-3421

Mailing address

2549 Burningbush Dr
Sterling Heights, MI 48314-4525
Phone (586) 604-9609

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
4704289322MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1481328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481328000000",
    "number": "1124562186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2549 BURNINGBUSH DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483144525",
            "telephone_number": "586-604-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38855 HILLS TECH DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313421",
            "telephone_number": "248-745-4900",
            "fax_number": "248-994-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "JOHNY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-10",
        "last_updated": "2016-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704289322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.