NPIMap

Organization Active NPI

Self-Reliance

  • Family Medicine Physician
  • Canton, MI
National Provider Identifier
1326622663
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SELF-RELIANCE
Practice address
1161 Stacy Dr
Canton, MI 48188-1426
Phone
(313) 740-5358
NPI assigned
May 12, 2021
Last updated
May 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Authorized official

Name
Lucinda PryorNPI 1003343369
Title
Owner
Phone
(313) 740-5358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1161 Stacy Dr
Canton, MI 48188-1426

Mailing address

1161 Stacy Dr
Canton, MI 48188-1426

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1326622663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 STACY DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 STACY DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881426",
            "telephone_number": "313-740-5358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF-RELIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-740-5358"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "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 May 26, 2021; 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.