Individual provider Active NPI

Danielle Christine Talavera

  • Pediatric Nurse Practitioner
  • Waterford, MI
National Provider Identifier
1417461807
Registry record updated Nov 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704291021 Issued in MI
Practice address
2561 Elizabeth Lake Rd
Waterford, MI 48328-3313
Phone
(248) 682-3300
NPI assigned
Nov 22, 2017
Last updated
Nov 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704291021 MI Primary

Addresses

Primary practice location

2561 Elizabeth Lake Rd
Waterford, MI 48328-3313

Mailing address

43105 Providence LN
Canton, MI 48188-5282
Phone (734) 730-6922

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
4704291021MIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Devyani Khambete, M.D.,P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dani@pediatricandadolescentcenter.direct.emds.com
  • Direct secure messaging: dtalavera552904@direct.hfhs.org

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, 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": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1417461807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43105 PROVIDENCE LN",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481885282",
            "telephone_number": "734-730-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2561 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283313",
            "telephone_number": "248-682-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALAVERA",
        "first_name": "DANIELLE",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704291021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.