Active NPI
Amy Parenteau, NP-C
- Family Nurse Practitioner
- Southgate, MI
National Provider Identifier
1295116804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704278758
- Practice address
- 12811 Northline Rd
Southgate, MI 48195-1109 - Phone
- (734) 283-4600
- Fax
- (734) 283-4683
- NPI assigned
- Jun 10, 2015
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704278758 | MI | Primary |
Addresses
Primary practice location
12811 Northline Rd
Southgate, MI 48195-1109
Mailing address
12811 Northline Rd
Southgate, MI 48195-1109
Phone (734) 283-4600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N88950002 | Other | MI | MEDICARE |
| MI8823002 | Other | MI | MEDICARE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555545600000",
"number": "1295116804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12811 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481951109",
"telephone_number": "734-283-4600",
"fax_number": "734-283-4683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12811 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481951109",
"telephone_number": "734-283-4600",
"fax_number": "734-283-4683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARENTEAU",
"first_name": "AMY",
"name_prefix": "Mrs.",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-10",
"last_updated": "2019-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704278758",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "N88950002",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "MI8823002",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.