Individual provider Active NPI

Diana Wilson

  • Non-emergency Medical Transport (VAN)
  • Detroit, MI
National Provider Identifier
1164833653
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
MDOT-71649 Issued in MI
Practice address
6551 Grand River Ave
Detroit, MI 48208-1125
Phone
(313) 656-4494
Fax
(313) 656-4494
NPI assigned
May 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X MDOT-71649 MI Primary

Addresses

Primary practice location

6551 Grand River Ave
Detroit, MI 48208-1125

Mailing address

6551 Grand River Ave
Detroit, MI 48208-1125
Phone (313) 656-4494

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
MDOT-71649MIMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1164833653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081125",
            "telephone_number": "313-656-4494",
            "fax_number": "313-656-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081125",
            "telephone_number": "313-656-4494",
            "fax_number": "313-656-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MI",
            "license": "MDOT-71649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.