Active NPI
Daniel B Fletcher, BA, BC-HIS
- Hearing Instrument Specialist
- Southgate, MI
National Provider Identifier
1164486379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 3501002179
- Practice address
- 13123 Eureka Rd
Southgate, MI 48195-1345 - Phone
- (734) 282-7991
- Fax
- (734) 282-8925
- NPI assigned
- Apr 14, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 3501002179 | MI | Primary |
Addresses
Primary practice location
13123 Eureka Rd
Southgate, MI 48195-1345
Mailing address
13123 Eureka Rd
Southgate, MI 48195-1345
Phone (734) 282-7991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4207196 | Medicaid | MI |
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3501002179 | MI | MD | Hearing Instrument Specialist |
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164486379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13123 EUREKA RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481951345",
"telephone_number": "734-282-7991",
"fax_number": "734-282-8925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13123 EUREKA RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481951345",
"telephone_number": "734-282-7991",
"fax_number": "734-282-8925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "DANIEL",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "BA, BC-HIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "MI",
"license": "3501002179",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4207196",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.