Organization Active NPI

J E Laird 1 LLC

  • Counselor
  • Flushing, MI
National Provider Identifier
1861035461
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
J E LAIRD 1 LLC
Practice address
5265 W Pierson Rd
Flushing, MI 48433-2461
Phone
(810) 715-9029
NPI assigned
Oct 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Authorized official

Name
Joseph E LairdNPI 1902192255
Title
Ceo
Phone
(810) 210-7429

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

5265 W Pierson Rd
Flushing, MI 48433-2461

Mailing address

6362 Boulder Dr
Flushing, MI 48433-3503
Phone (810) 210-7429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200225001866 MI Part B Supplier - Clinic/Group Practice 0244667673 Receives reassigned benefits from 2 practitioners
Practice locations: Flushing, MI

National Provider Directory

National Provider Directory

Locations

5265 W Pierson Rd
Flushing, MI 48433
Phone (810) 715-9029

5255 W Pierson Rd
Ste 1A
Flushing, MI 48433
Phone (810) 715-9029

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1572048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1861035461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6362 BOULDER DR",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484333503",
            "telephone_number": "810-210-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5265 W PIERSON RD",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484332461",
            "telephone_number": "810-715-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J E LAIRD 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-26",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "LAIRD",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-210-7429"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.