Active NPI
Mary Anne Halstead, LPN
- Licensed Practical Nurse
- Toledo, OH
National Provider Identifier
1811065659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN104570
- Practice address
- 4538 Torquay
Toledo, OH 43615 - Phone
- (419) 841-6648
- NPI assigned
- Dec 1, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703078336 | MI | |
| Licensed Practical Nurse | 164W00000X | PN104570 | OH | Primary |
Addresses
Primary practice location
4538 Torquay
Toledo, OH 43615
Mailing address
2512 Echo Rd
Toledo, OH 43613
Phone (419) 475-3054
Other practice location 1
27777 Inkster Rd
Farmington Hills, MI 48334-5310
Phone (855) 772-8847
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2236100 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4703078336 | MI | MD | Licensed Practical Nurse |
| PN104570 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1811065659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2512 ECHO RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "43613",
"telephone_number": "419-475-3054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4538 TORQUAY",
"city": "TOLEDO",
"state": "OH",
"postal_code": "43615",
"telephone_number": "419-841-6648"
}
],
"practiceLocations": [
{
"address_1": "27777 Inkster Rd",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483345310",
"country_code": "US",
"telephone_number": "855-772-8847",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HALSTEAD",
"first_name": "MARY ANNE",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703078336",
"primary": false
},
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN104570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2236100",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.