Individual provider Active NPI

James Edward Vereb, LPN

  • Licensed Practical Nurse
  • Gwinn, MI
National Provider Identifier
1609244029
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703079492 Issued in MI
Practice address
480 W Washington St
Gwinn, MI 49841-9514
Phone
(906) 458-4080
NPI assigned
Sep 2, 2015
Last updated
Sep 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703079492 MI Primary

Addresses

Primary practice location

480 W Washington St
Gwinn, MI 49841-9514

Mailing address

480 W Washington St
Gwinn, MI 49841-9514
Phone (906) 458-4080

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

LicenseStateTypeSpecialty
4703079492MIMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1609244029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 W WASHINGTON ST",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498419514",
            "telephone_number": "906-458-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 W WASHINGTON ST",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498419514",
            "telephone_number": "906-458-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEREB",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703079492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gwinn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.

Verify at the official NPI Registry.