Active NPI
Candis Harris
- Nurse's Aide
- Flint, MI
National Provider Identifier
1558732156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 238034741095
- Practice address
- 1601 Earlmoor Blvd
Flint, MI 48506-3954 - Phone
- (810) 845-8919
- Fax
- (810) 744-0548
- NPI assigned
- Oct 8, 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 238034741095 | MI | Primary |
Addresses
Primary practice location
1601 Earlmoor Blvd
Flint, MI 48506-3954
Mailing address
1601 Earlmoor Blvd
Flint, MI 48506-3954
Phone (810) 845-8919
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 |
|---|---|---|---|
| 238034741095 | MI | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444262400000",
"number": "1558732156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 EARLMOOR BLVD",
"city": "FLINT",
"state": "MI",
"postal_code": "485063954",
"telephone_number": "810-845-8919",
"fax_number": "810-744-0548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 EARLMOOR BLVD",
"city": "FLINT",
"state": "MI",
"postal_code": "485063954",
"telephone_number": "810-845-8919",
"fax_number": "810-744-0548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CANDIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2015-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "MI",
"license": "238034741095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.