Active NPI
Lauryn Alexus McKenney
- Licensed Practical Nurse
- Detroit, MI
National Provider Identifier
1679399604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703121534
- Practice address
- 674 Glynn CT
Detroit, MI 48202-1451 - Phone
- (313) 707-0090
- NPI assigned
- Nov 25, 2024
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703121534 | MI | Primary |
Addresses
Primary practice location
674 Glynn CT
Detroit, MI 48202-1451
Mailing address
220 W Congress St # 1024
Detroit, MI 48226-3289
Phone (313) 513-2400
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 |
|---|---|---|---|
| 4703121534 | MI | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abundant Living Staffing Agency LLC | Current | Accepting new patients | |
| Healthy Living Estates | Current | Accepting new patients | |
| Living Splendidly Afc Home | Current | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Detroit, MI
- NPI 1225868425
-
- Physical Disabilities Residential Treatment Facility
- Detroit, MI
- NPI 1003632027
-
- Mental Illness Community Based Residential Treatment Facility
- Detroit, MI
- NPI 1376369397
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1679399604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 W CONGRESS ST # 1024",
"city": "DETROIT",
"state": "MI",
"postal_code": "482263289",
"telephone_number": "313-513-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "674 GLYNN CT",
"city": "DETROIT",
"state": "MI",
"postal_code": "482021451",
"telephone_number": "313-707-0090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNEY",
"first_name": "LAURYN",
"middle_name": "ALEXUS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-25",
"last_updated": "2024-11-25",
"certification_date": "2024-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703121534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.