Active NPI
Quenessa C Miller
- Other Technician
- Detroit, MI
National Provider Identifier
1366959710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 400 Renaissance Ctr Ste 2600
Detroit, MI 48243 - Phone
- (855) 832-6727
- NPI assigned
- Jan 8, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Health Information Technician | 247000000X | MI | ||
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
400 Renaissance Ctr Ste 2600
Detroit, MI 48243
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727
Other practice location 1
400 Renaissance Ctr Ste 2600
Detroit, MI 48243
Phone (855) 832-6727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 247200000X | Medicaid | MI |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canises LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Home Health Agency
- Bay City, MI
- NPI 1295556363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1366959710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 RENAISSANCE CTR STE 2600",
"city": "DETROIT",
"state": "MI",
"postal_code": "48243",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [
{
"address_1": "400 Renaissance Ctr Ste 2600",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "48243",
"country_code": "US",
"telephone_number": "855-832-6727",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "QUENESSA",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-08",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "247000000X",
"taxonomy_group": "",
"desc": "Technician, Health Information",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "247200000X",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.