Active NPI
Victoria Patterson
- Prosthetic/Orthotic Supplier
- Detroit, MI
National Provider Identifier
1740791193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- 2701169133
- Practice address
- 7521 Michigan Ave
Detroit, MI 48210-2229 - Phone
- (313) 436-4661
- NPI assigned
- Oct 12, 2017
- 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 |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | 2701169133 | MI | Primary |
Addresses
Primary practice location
7521 Michigan Ave
Detroit, MI 48210-2229
Mailing address
4905 Madison St
Dearborn Heights, MI 48125-2363
Phone (313) 412-5171
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 |
|---|---|---|---|
| 2701169133 | MI | MD | Prosthetic/Orthotic Supplier |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507766400000",
"number": "1740791193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4905 MADISON ST",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481252363",
"telephone_number": "313-412-5171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7521 MICHIGAN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482102229",
"telephone_number": "313-436-4661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "VICTORIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-12",
"last_updated": "2017-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "MI",
"license": "2701169133",
"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 Oct 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.