Individual provider Active NPI

Traci L Rasor, RN

  • General Practice Registered Nurse
  • Northville, MI
National Provider Identifier
1396159083
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
4704222096 Issued in MI
Practice address
143 Cadycentre Unit 250
Northville, MI 48167
Phone
(313) 330-0505
NPI assigned
Jun 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 4704222096 MI Primary

Addresses

Primary practice location

143 Cadycentre Unit 250
Northville, MI 48167

Mailing address

143 Cadycentre Unit 250
Northville, MI 48167
Phone (313) 330-0505

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704222096MIMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1396159083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 CADYCENTRE UNIT 250",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "48167",
            "telephone_number": "313-330-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 CADYCENTRE UNIT 250",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "48167",
            "telephone_number": "313-330-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASOR",
        "first_name": "TRACI",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MI",
            "license": "4704222096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.