Active NPI
Lily Jin
- Student in an Organized Health Care Education/Training Program
- Detroit, MI
National Provider Identifier
1215329982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3901 Beaubien St
Detroit, MI 48201-2119 - Phone
- (301) 222-7086
- NPI assigned
- Mar 4, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3901 Beaubien St
Detroit, MI 48201-2119
Mailing address
6036 Chatsworth LN
Bethesda, MD 20814-2206
Phone (301) 222-7086
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63178842 | Other | MD | KAISER PERMANENTE |
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": "1425427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425427200000",
"number": "1215329982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6036 CHATSWORTH LN",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208142206",
"telephone_number": "301-222-7086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 BEAUBIEN ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012119",
"telephone_number": "301-222-7086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIN",
"first_name": "LILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-04",
"last_updated": "2015-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER PERMANENTE",
"identifier": "63178842",
"state": "MD"
}
],
"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 Mar 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.