Individual provider Active NPI

Jeanne M Ford, LPN

  • Licensed Practical Nurse
  • Rochester Hills, MI
National Provider Identifier
1962637785
Registry record updated May 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703090171 Issued in MI
Practice address
2619 Product Dr
# 106
Rochester Hills, MI 48309-3807
Phone
(248) 844-9650
Fax
(248) 844-9651
NPI assigned
May 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703090171 MI Primary

Addresses

Primary practice location

2619 Product Dr
# 106
Rochester Hills, MI 48309-3807

Mailing address

2619 Product Drive
# 106
Rochester Hills, MI 48309
Phone (248) 844-9650

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
4703090171MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242950400000",
    "number": "1962637785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 PRODUCT DRIVE",
            "address_2": "# 106",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48309",
            "telephone_number": "248-844-9650",
            "fax_number": "248-844-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 PRODUCT DR",
            "address_2": "# 106",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093807",
            "telephone_number": "248-844-9650",
            "fax_number": "248-844-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JEANNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2009-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703090171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; 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.