Active NPI
William Brooks, LVN
- Licensed Practical Nurse
- New Hudson, MI
National Provider Identifier
1942748876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703117205
- Practice address
- 29800 Glynn Lee CT
New Hudson, MI 48165-9523 - Phone
- (248) 862-4898
- NPI assigned
- Feb 12, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703117205 | MI | Primary |
Addresses
Primary practice location
29800 Glynn Lee CT
New Hudson, MI 48165-9523
Mailing address
29800 Glynn Lee CT
New Hudson, MI 48165-9523
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4703117205 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4703117205 | MI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486857600000",
"number": "1942748876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29800 GLYNN LEE CT",
"city": "NEW HUDSON",
"state": "MI",
"postal_code": "481659523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29800 GLYNN LEE CT",
"city": "NEW HUDSON",
"state": "MI",
"postal_code": "481659523",
"telephone_number": "248-862-4898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "WILLIAM",
"credential": "LVN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-12",
"last_updated": "2017-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703117205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4703117205",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Hudson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.