Individual provider Active NPI

Brenda Liz Serrano-Nieves

  • Case Manager/Care Coordinator
  • Detroit, MI
National Provider Identifier
1811402878
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
S655098522883 Issued in MI
Practice address
1700 Waterman St
Detroit, MI 48209-2022
Phone
(313) 841-8900
Fax
(313) 841-3756
NPI assigned
Dec 12, 2017
Last updated
Dec 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X S655098522883 MI Primary

Addresses

Primary practice location

1700 Waterman St
Detroit, MI 48209-2022

Mailing address

2541 S Liddesdale St
Detroit, MI 48217-1195

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
S655098522883MIMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1811402878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 S LIDDESDALE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482171195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WATERMAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482092022",
            "telephone_number": "313-841-8900",
            "fax_number": "313-841-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO-NIEVES",
        "first_name": "BRENDA",
        "middle_name": "LIZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "S655098522883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.