Individual provider Active NPI

Alix Diana McGinn

  • Licensed Practical Nurse
  • Hubbardston, MI
National Provider Identifier
1508574377
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703126124 Issued in MI
Practice address
10184 McKenna Rd
Hubbardston, MI 48845-9509
Phone
(517) 914-0700
NPI assigned
Nov 10, 2022
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703126124 MI Primary

Addresses

Primary practice location

10184 McKenna Rd
Hubbardston, MI 48845-9509

Mailing address

10184 McKenna Rd
Hubbardston, MI 48845-9509
Phone (517) 914-0700

Other identifiers 1

IdentifierTypeStateIssuer
164W00000XOtherMISTATE OF MICHIGAN

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
4703126124MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1508574377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10184 MCKENNA RD",
            "city": "HUBBARDSTON",
            "state": "MI",
            "postal_code": "488459509",
            "telephone_number": "517-914-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10184 MCKENNA RD",
            "city": "HUBBARDSTON",
            "state": "MI",
            "postal_code": "488459509",
            "telephone_number": "517-914-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINN",
        "first_name": "ALIX",
        "middle_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703126124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "164W00000X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hubbardston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.