Mari I Debolt

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

1934415 Issued in MI

Practice address

123 N Pine St
Saint Louis, MI 48880-1428

Phone

(989) 721-0857

NPI assigned

Jun 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mari'S Cleaning and Senior Care Services

  • Home Health Agency
  • Saint Louis, MI
  • NPI 1013579168
  NPD Authorized official

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1265092589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N PINE ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801428",
            "telephone_number": "989-721-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N PINE ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801428",
            "telephone_number": "989-721-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOLT",
        "first_name": "MARI",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "MI",
            "license": "1934415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMERGENCY MEDICAL TECHNICIAN LICENSE",
            "identifier": "1934415",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Carol Chatelain, MS-CCC-SLP
• Lundi Ann Cornell, LAC, RN
• Creative Autism Treatments
• Judy L Crockett, MA, LPC
• Nicki Elizabeth Croel-Darter, RN
• Delta Chiropractic Center,P.L.L.C.
• Paige Marie Dines, DC
• Justin Michael Elliott, OTRL
• Evans Drugs of Saint Louis LLC
• Janet Lynn Ferguson

• Basic Emergency Medical Technician in Saint Louis, MI
• Providers in Saint Louis, MI by specialty
• Basic Emergency Medical Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.