Individual provider Active NPI

Amanda Pestridge

  • Other Technician
  • Mount Pleasant, MI
National Provider Identifier
1760926489
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
3300 E Deerfield Rd
Apt. B361
Mount Pleasant, MI 48858-4535
Phone
(810) 623-8488
NPI assigned
Dec 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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 Primary

Addresses

Primary practice location

3300 E Deerfield Rd
Apt. B361
Mount Pleasant, MI 48858-4535

Mailing address

3300 E Deerfield Rd
Apt. B361
Mount Pleasant, MI 48858-4535
Phone (810) 623-8488

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": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1760926489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E DEERFIELD RD",
            "address_2": "APT. B361",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488584535",
            "telephone_number": "810-623-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E DEERFIELD RD",
            "address_2": "APT. B361",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488584535",
            "telephone_number": "810-623-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESTRIDGE",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.