Active NPI
Antionette Scandrick
- Licensed Practical Nurse
- Flint, MI
National Provider Identifier
1275979957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703102863
- Practice address
- 4433 Miller Road
Flint, MI 48507 - Phone
- (810) 733-1185
- NPI assigned
- May 21, 2013
- Last updated
- May 21, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703102863 | MI | Primary |
Addresses
Primary practice location
4433 Miller Road
Flint, MI 48507
Mailing address
4433 Miller Road
Flint, MI 48507
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 |
|---|---|---|---|
| 4703102863 | MI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369094400000",
"number": "1275979957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4433 MILLER ROAD",
"city": "FLINT",
"state": "MI",
"postal_code": "48507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4433 MILLER ROAD",
"city": "FLINT",
"state": "MI",
"postal_code": "48507",
"telephone_number": "810-733-1185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCANDRICK",
"first_name": "ANTIONETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-21",
"last_updated": "2013-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703102863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.