Active NPI
Godwin Ilonze
- Home Health Aide
- Hazel Park, MI
National Provider Identifier
1245959873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- AS630386442
- Practice address
- 388 W Hayes Ave
Hazel Park, MI 48030-2411 - Phone
- (313) 377-4486
- NPI assigned
- Aug 25, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | AS630386442 | MI | Primary |
Addresses
Primary practice location
388 W Hayes Ave
Hazel Park, MI 48030-2411
Mailing address
388 W Hayes Ave
Hazel Park, MI 48030-2411
Phone (313) 377-4486
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
| License | State | Type | Specialty |
|---|---|---|---|
| AS630386442 | MI | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1245959873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "388 W HAYES AVE",
"city": "HAZEL PARK",
"state": "MI",
"postal_code": "480302411",
"telephone_number": "313-377-4486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "388 W HAYES AVE",
"city": "HAZEL PARK",
"state": "MI",
"postal_code": "480302411",
"telephone_number": "313-377-4486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILONZE",
"first_name": "GODWIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-25",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MI",
"license": "AS630386442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazel Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.