Mondreek Whack

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

4125 Dove Rd Lot 49
Port Huron, MI 48060-7458

Phone

(248) 658-8665

NPI assigned

Dec 5, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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": "1891562344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 DOVE RD",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480607454",
            "telephone_number": "248-658-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 DOVE RD LOT 49",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480607458",
            "telephone_number": "248-658-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHACK",
        "first_name": "MONDREEK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thelma Yerisen West, LMSW
• Autumn Lynn Westbrook
• Sherri Westbrook, M.S., L.L.P.
• Sydney Rae Westfall, LLMSW
• Valerie Wetzel, N.P.
• Traci Lynn Wheeler
• Mark James White
• Marie Whitehead
• Jason A Whiting
• Laura Ann Whittaker, LMSW

• Personal Care Attendant in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Personal Care Attendant in Michigan

• 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.