Individual provider Active NPI

Nickole Nefititi Triplett

  • Registered Nurse
  • Warren, MI
National Provider Identifier
1376422212
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704261477 Issued in MI
Practice address
12200 E 13 Mile Rd
Warren, MI 48093-3093
Phone
(586) 573-1810
NPI assigned
Aug 27, 2025
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704261477 MI Primary

Addresses

Primary practice location

12200 E 13 Mile Rd
Warren, MI 48093-3093

Mailing address

27290 Devonshire St
Southfield, MI 48076-5637
Phone (313) 779-0018

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
4704261477MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Judson Center, Inc. PastSince Sep 3, 2025 Accepting new patients
Judson Center, Inc. PastSince Sep 3, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1376422212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27290 DEVONSHIRE ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480765637",
            "telephone_number": "313-779-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933093",
            "telephone_number": "586-573-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPLETT",
        "first_name": "NICKOLE",
        "middle_name": "NEFITITI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704261477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.