Active NPI
Daniel O Flansburg
- Adult Care Home Facility
- Traverse City, MI
National Provider Identifier
1639588452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- AF280300565
- Practice address
- 5205 Goodrick Rd
Traverse City, MI 49684 - Phone
- (231) 935-3159
- Fax
- (231) 935-3159
- NPI assigned
- Aug 6, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | AF280300565 | MI | Primary |
Addresses
Primary practice location
5205 Goodrick Rd
Traverse City, MI 49684
Mailing address
5205 Goodrick Rd
Traverse City, MI 49684
Phone (231) 935-3159
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 |
|---|---|---|---|
| AF280300565 | MI | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407283200000",
"number": "1639588452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5205 GOODRICK RD",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-935-3159",
"fax_number": "231-935-3159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5205 GOODRICK RD",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-935-3159",
"fax_number": "231-935-3159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLANSBURG",
"first_name": "DANIEL",
"middle_name": "O",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-06",
"last_updated": "2014-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "MI",
"license": "AF280300565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.