Individual provider Active NPI

Dequann Walker

  • Other Technician
  • Pontiac, MI
National Provider Identifier
1720479090
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
2A Wedgewoode LN
Pontiac, MI 48340-2269
Phone
(859) 552-2803
NPI assigned
Feb 9, 2015
Last updated
Feb 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X NU Primary

Addresses

Primary practice location

2A Wedgewoode LN
Pontiac, MI 48340-2269

Mailing address

2A Wedgewoode LN
Pontiac, MI 48340-2269
Phone (859) 552-2803

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

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1720479090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2A WEDGEWOODE LN",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483402269",
            "telephone_number": "859-552-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2A WEDGEWOODE LN",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483402269",
            "telephone_number": "859-552-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "DEQUANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.