Individual provider Active NPI

Sade Glover

  • Community Health Worker
  • Detroit, MI
National Provider Identifier
1831966357
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
84289891 Issued in MI
Practice address
11000 W McNichols Rd Ste 323-1422
Detroit, MI 48221-2357
Phone
(586) 930-2445
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 84289891 MI Primary

Addresses

Primary practice location

11000 W McNichols Rd Ste 323-1422
Detroit, MI 48221-2357

Mailing address

12280 Wilshire Dr
Detroit, MI 48213-1729
Phone (586) 930-2445

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
84289891MIMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
24 7 Community Outreach Community Health Worker CurrentSince Dec 10, 2023 Accepting new patients

Locations

11000 W McNichols Rd
Ste 3231422
Detroit, MI 48221
Phone (586) 930-2445

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1831966357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12280 WILSHIRE DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482131729",
            "telephone_number": "586-930-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 W MCNICHOLS RD STE 323-1422",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212357",
            "telephone_number": "586-930-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "SADE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": "84289891",
            "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 5, 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.

Verify at the official NPI Registry.