Active NPI
Tanya Stovall
- Clinical Medical Laboratory
- Southfield, MI
National Provider Identifier
1154868644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 23D2176188
- Practice address
- 23330 Oak Glen Dr
Southfield, MI 48033-3491 - Phone
- (877) 436-4636
- Fax
- (877) 436-4636
- NPI assigned
- Jan 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | |||
| Clinical Medical Laboratory | 291U00000X | 23D2176188 | MI | Primary |
Addresses
Primary practice location
23330 Oak Glen Dr
Southfield, MI 48033-3491
Mailing address
23330 Oak Glen Dr
Southfield, MI 48033-3491
Phone (877) 436-4636
Other names 1
- Tanya Stovall
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23D2176188 | MI | MD | Clinical Medical Laboratory |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Venotech Phlebotomy | Phlebotomy | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Phlebotomy Technician
- Southfield, MI
- NPI 1548816135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579478400000",
"number": "1154868644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23330 OAK GLEN DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333491",
"telephone_number": "877-436-4636",
"fax_number": "877-436-4636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23330 OAK GLEN DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333491",
"telephone_number": "877-436-4636",
"fax_number": "877-436-4636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVALL",
"first_name": "TANYA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-23",
"last_updated": "2020-01-20",
"certification_date": "2020-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "MI",
"license": "23D2176188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TANYA",
"last_name": "STOVALL",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.