Individual provider Active NPI

Donica Kirkland

  • Licensed Practical Nurse
  • Canton, MI
National Provider Identifier
1306200332
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703114836 Issued in MI
Practice address
51074 Mott Rd TRLR 176
Canton, MI 48188-2160
Phone
(989) 714-9227
NPI assigned
Apr 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703114836 MI Primary

Addresses

Primary practice location

51074 Mott Rd TRLR 176
Canton, MI 48188-2160

Mailing address

51074 Mott Rd TRLR 176
Canton, MI 48188-2160
Phone (989) 714-9227

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

LicenseStateTypeSpecialty
4703114836MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1306200332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51074 MOTT RD TRLR 176",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882160",
            "telephone_number": "989-714-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51074 MOTT RD TRLR 176",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882160",
            "telephone_number": "989-714-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "DONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703114836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.