Individual provider Active NPI

Sheila Lacey-Willis, RN

  • Home Health Registered Nurse
  • Southfield, MI
National Provider Identifier
1750817847
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
4704131667 Issued in MI
Practice address
24263 Lathrup Blvd
Southfield, MI 48075-2838
Phone
(248) 388-9524
Fax
(248) 557-8115
NPI assigned
May 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 4704131667 MI Primary

Addresses

Primary practice location

24263 Lathrup Blvd
Southfield, MI 48075-2838

Mailing address

24263 Lathrup Blvd
Southfield, MI 48075-2838
Phone (248) 388-9524

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704131667MIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1750817847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24263 LATHRUP BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752838",
            "telephone_number": "248-388-9524",
            "fax_number": "248-557-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24263 LATHRUP BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752838",
            "telephone_number": "248-388-9524",
            "fax_number": "248-557-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY-WILLIS",
        "first_name": "SHEILA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MI",
            "license": "4704131667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.

Verify at the official NPI Registry.