Active NPI
Destiny J Landers
- Contractor
- Rosharon, TX
National Provider Identifier
1376252080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 919 Modesto Dr
Rosharon, TX 77583-3754 - Phone
- (346) 391-7291
- NPI assigned
- Nov 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
919 Modesto Dr
Rosharon, TX 77583-3754
Mailing address
919 Modesto Dr
Rosharon, TX 77583-3754
Phone (346) 391-7291
Other names 1
- Destined 4 Greatness
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1376252080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 MODESTO DR",
"city": "ROSHARON",
"state": "TX",
"postal_code": "775833754",
"telephone_number": "346-391-7291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "919 MODESTO DR",
"city": "ROSHARON",
"state": "TX",
"postal_code": "775833754",
"telephone_number": "346-391-7291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDERS",
"first_name": "DESTINY",
"middle_name": "J",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-21",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DESTINED",
"last_name": "GREATNESS",
"middle_name": "4",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Rosharon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.