L Brintley MD PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

L BRINTLEY MD PLLC

Practice address

2617 W Grand Blvd
Detroit, MI 48208-1234

Phone

(734) 464-3400

Fax

(734) 464-4550

NPI assigned

Jan 14, 2007

Organization subpart

No

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

Authorized official

Name

Lacesha Brintley, MDNPI 1942278320

Title

Ownerphysician

Phone

(734) 464-3400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lacesha Brintley, MD

  • Surgery Physician
  • Detroit, MI
  • NPI 1942278320
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1801947239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081234",
            "telephone_number": "734-464-3400",
            "fax_number": "734-464-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081234",
            "telephone_number": "734-464-3400",
            "fax_number": "734-464-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L BRINTLEY MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-14",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "BRINTLEY",
        "authorized_official_first_name": "LACESHA",
        "authorized_official_title_or_position": "OWNERPHYSICIAN",
        "authorized_official_telephone_number": "734-464-3400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.