Phillip Glenn Lougheed, FNP-BC, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F10201475 Issued in MI

Practice address

24255 W 13 Mile Rd
Bingham Farms, MI 48025-4320

Phone

(248) 723-9613

NPI assigned

Jan 27, 2021

Last updated

Jan 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1215528997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 WALNUT AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480735310",
            "telephone_number": "810-938-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24255 W 13 MILE RD",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254320",
            "telephone_number": "248-723-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHEED",
        "first_name": "PHILLIP",
        "middle_name": "GLENN",
        "credential": "FNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "F10201475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.