Active NPI
Marjan Bagheri
- Personal Care Attendant
- Davie, FL
National Provider Identifier
1770887580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 12555 Orange Dr
Suite 222
Davie, FL 33330-4304 - Phone
- (954) 862-1707
- NPI assigned
- Jan 8, 2011
- Last updated
- Jan 8, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
12555 Orange Dr
Suite 222
Davie, FL 33330-4304
Mailing address
1021 Mockingbird LN
Apt 118
Plantation, FL 33324-3410
Phone (954) 234-3454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001885400 | Medicaid | FL |
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": "1294444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294444800000",
"number": "1770887580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 MOCKINGBIRD LN",
"address_2": "APT 118",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333243410",
"telephone_number": "954-234-3454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12555 ORANGE DR",
"address_2": "SUITE 222",
"city": "DAVIE",
"state": "FL",
"postal_code": "333304304",
"telephone_number": "954-862-1707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGHERI",
"first_name": "MARJAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-08",
"last_updated": "2011-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001885400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.