Active NPI
Jeff Vailu
- Licensed Practical Nurse
- Flat Rock, MI
National Provider Identifier
1609229335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703108476
- Practice address
- 28880 Appleblossom Drive
Flat Rock, MI 48134-3151 - Phone
- (734) 642-5932
- NPI assigned
- Jul 18, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703108476 | MI | Primary |
Addresses
Primary practice location
28880 Appleblossom Drive
Flat Rock, MI 48134-3151
Mailing address
28880 Apple Bloosm Drive
Flat Rock, MI 48134-3151
Phone (734) 782-5932
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 |
|---|---|---|---|
| 4703108476 | MI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1609229335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28880 APPLE BLOOSM DRIVE",
"city": "FLAT ROCK",
"state": "MI",
"postal_code": "481343151",
"telephone_number": "734-782-5932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28880 APPLEBLOSSOM DRIVE",
"city": "FLAT ROCK",
"state": "MI",
"postal_code": "481343151",
"telephone_number": "734-642-5932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAILU",
"first_name": "JEFF",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-18",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703108476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flat Rock, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.