Active NPI
Candi Purdiman
- Community Health Worker
- Benton Harbor, MI
National Provider Identifier
1902640246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 133 W Main St
Benton Harbor, MI 49022-3607 - Phone
- (269) 408-2258
- NPI assigned
- Jun 21, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | MI | Primary |
Addresses
Primary practice location
133 W Main St
Benton Harbor, MI 49022-3607
Mailing address
1181 Monroe St
Benton Harbor, MI 49022-5225
Phone (269) 759-3305
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1902640246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1181 MONROE ST",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490225225",
"telephone_number": "269-759-3305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 W MAIN ST",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490223607",
"telephone_number": "269-408-2258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURDIMAN",
"first_name": "CANDI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.