Active NPI
Jorvon Brison Sr.
- Home Health Aide
- Detroit, MI
National Provider Identifier
1518788868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 5785155
- Practice address
- 18400 Monte Vista St
Detroit, MI 48221-1951 - Phone
- (424) 333-0073
- NPI assigned
- Oct 21, 2024
- Last updated
- Oct 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 5785155 | MI | Primary |
Addresses
Primary practice location
18400 Monte Vista St
Detroit, MI 48221-1951
Mailing address
18400 Monte Vista St
Detroit, MI 48221-1951
Phone (424) 333-0073
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5785155 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5785155 | MI | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1518788868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18400 MONTE VISTA ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482211951",
"telephone_number": "424-333-0073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18400 MONTE VISTA ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482211951",
"telephone_number": "424-333-0073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISON",
"first_name": "JORVON",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-21",
"last_updated": "2024-10-21",
"certification_date": "2024-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MI",
"license": "5785155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5785155",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.