Individual provider Active NPI

Nicole R Beecher

  • Nurse's Aide
  • Lathrup Village, MI
National Provider Identifier
1619502044
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
MI000055804 Issued in MI
Practice address
26211 Central Park Blvd Ste 116
Lathrup Village, MI 48076-4107
Phone
(248) 671-3022
NPI assigned
Mar 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X B260630729782 MI
Chore Provider 372500000X
Adult Companion 372600000X
Attendant Care Provider 3747A0650X
Personal Care Attendant 3747P1801X
Home Health Aide 374U00000X
Prevention Professional 405300000X MI000055804 MI
Nurse's Aide 376K00000X MI000055804 MI Primary

Addresses

Primary practice location

26211 Central Park Blvd Ste 116
Lathrup Village, MI 48076-4107

Mailing address

6725 Daly Rd Unit 251503
West Bloomfield, MI 48325-3262
Phone (248) 277-6011

Other identifiers 1

IdentifierTypeStateIssuer
000055804OtherMISTATE OF MICHIGAN

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
B260630729782MIMDDriver
MI000055804MIMDPrevention Professional

NPI Registry JSON

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1619502044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 DALY RD UNIT 251503",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483253262",
            "telephone_number": "248-277-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26211 CENTRAL PARK BLVD STE 116",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764107",
            "telephone_number": "248-671-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEECHER",
        "first_name": "NICOLE",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MI",
            "license": "B260630729782",
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "MI",
            "license": "MI000055804",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MI",
            "license": "MI000055804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "000055804",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lathrup Village, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.