Individual provider Active NPI

Renita Agnew

  • Contractor
  • Sterling Heights, MI
National Provider Identifier
1235529264
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
36869 Carriage Dr
Sterling Heights, MI 48310-4474
Phone
(313) 460-3753
Fax
(313) 460-3753
NPI assigned
Jan 29, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

36869 Carriage Dr
Sterling Heights, MI 48310-4474

Mailing address

36869 Carriage Dr
Sterling Heights, MI 48310-4474
Phone (313) 460-3753

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": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1235529264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36869 CARRIAGE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104474",
            "telephone_number": "313-460-3753",
            "fax_number": "313-460-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36869 CARRIAGE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104474",
            "telephone_number": "313-460-3753",
            "fax_number": "313-460-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "RENITA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.

Verify at the official NPI Registry.