Active NPI
Laquita Mims
- Other Technician
- Southfield, MI
National Provider Identifier
1528441367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 24455 Lee Baker Dr
Southfield, MI 48075-2509 - Phone
- (989) 430-6839
- NPI assigned
- Jun 29, 2015
- Last updated
- Jun 29, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | NU | Primary |
Addresses
Primary practice location
24455 Lee Baker Dr
Southfield, MI 48075-2509
Mailing address
24455 Lee Baker Dr
Southfield, MI 48075-2509
Phone (989) 430-6839
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435536000000",
"number": "1528441367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24455 LEE BAKER DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752509",
"telephone_number": "989-430-6839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24455 LEE BAKER DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752509",
"telephone_number": "989-430-6839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIMS",
"first_name": "LAQUITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-29",
"last_updated": "2015-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.