Individual provider Active NPI

Leann Nicole Munaco, FNP-BC

  • Family Nurse Practitioner
  • Eastpointe, MI
National Provider Identifier
1245616788
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704270312 Issued in MI
Practice address
21300 Kelly Rd
Eastpointe, MI 48021-3232
Phone
(586) 447-4200
Fax
(586) 447-4208
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704270312 MI Primary
Registered Nurse 163W00000X 470427012 MI

Addresses

Primary practice location

21300 Kelly Rd
Eastpointe, MI 48021-3232

Mailing address

21300 Kelly Rd
Eastpointe, MI 48021-3232
Phone (586) 447-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160615001037 MI Practitioner - Nurse Practitioner 0143511568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
470427012MIMDRegistered Nurse

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1245616788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21300 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213232",
            "telephone_number": "586-447-4200",
            "fax_number": "586-447-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213232",
            "telephone_number": "586-447-4200",
            "fax_number": "586-447-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNACO",
        "first_name": "LEANN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704270312",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "470427012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

Verify at the official NPI Registry.