Individual provider Active NPI

Terrie Walton-Banks

  • Registered Nurse
  • Southfield, MI
National Provider Identifier
1801272158
Registry record updated Aug 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704290325 Issued in MI
Practice address
24740 Thorndyke St
Southfield, MI 48033-7032
Phone
(313) 550-4473
NPI assigned
Aug 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704290325 MI Primary

Addresses

Primary practice location

24740 Thorndyke St
Southfield, MI 48033-7032

Mailing address

24740 Thorndyke St
Southfield, MI 48033-7032
Phone (313) 550-4473

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

LicenseStateTypeSpecialty
4704290325MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1439078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439078400000",
    "number": "1801272158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24740 THORNDYKE ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480337032",
            "telephone_number": "313-550-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24740 THORNDYKE ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480337032",
            "telephone_number": "313-550-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON-BANKS",
        "first_name": "TERRIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-09",
        "last_updated": "2015-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704290325",
            "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 Aug 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.