Active NPI
Angela Johnson
- Clinical Medical Laboratory
- Detroit, MI
National Provider Identifier
1538542964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Practice address
- 17300 Santa Barbara Dr
Detroit, MI 48221-2527 - Phone
- (313) 926-9541
- NPI assigned
- Jul 2, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
17300 Santa Barbara Dr
Detroit, MI 48221-2527
Mailing address
PO Box 47174
Oak Park, MI 48237-4874
Phone (844) 932-5663
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": "1435795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435795200000",
"number": "1538542964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 47174",
"city": "OAK PARK",
"state": "MI",
"postal_code": "482374874",
"telephone_number": "844-932-5663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17300 SANTA BARBARA DR",
"city": "DETROIT",
"state": "MI",
"postal_code": "482212527",
"telephone_number": "313-926-9541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ANGELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-02",
"last_updated": "2015-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jul 2, 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.