Individual provider Active NPI

Joshua Madison Maciejewski

  • Student in an Organized Health Care Education/Training Program
  • South Rockwood, MI
National Provider Identifier
1801536081
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
12640 Stoneridge LN Apt 204
South Rockwood, MI 48179-9555
Phone
(813) 579-8061
NPI assigned
Mar 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

12640 Stoneridge LN Apt 204
South Rockwood, MI 48179-9555

Mailing address

12640 Stoneridge LN Apt 204
South Rockwood, MI 48179-9555
Phone (813) 579-8061

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1801536081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12640 STONERIDGE LN APT 204",
            "city": "SOUTH ROCKWOOD",
            "state": "MI",
            "postal_code": "481799555",
            "telephone_number": "813-579-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12640 STONERIDGE LN APT 204",
            "city": "SOUTH ROCKWOOD",
            "state": "MI",
            "postal_code": "481799555",
            "telephone_number": "813-579-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIEJEWSKI",
        "first_name": "JOSHUA",
        "middle_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Rockwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.