Mavis Gail Pookrum

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

21732 Colony Park Circle #105
Southfield, MI 48076

Phone

(313) 283-7838

NPI assigned

Nov 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1386114742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21732 COLONY PARK CIRCLE #105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48076",
            "telephone_number": "313-283-7838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21732 COLONY PARK CIRCLE #105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48076",
            "telephone_number": "313-283-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOKRUM",
        "first_name": "MAVIS",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liba Polter, LMSW
• Yaakov Y Polter, M.S. LLPC
• Polyclinic Associates PC
• Amanda Marie Poncil, LMSW
• Peter Ponomarev
• Devin Poole
• Jennifer Poole
• Stephanie Jacinta Poole
• Chantal Nicole Pope
• Sandra Pope

• Personal Care Attendant in Southfield, MI
• Providers in Southfield, MI by specialty
• Personal Care Attendant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.