Individual provider Active NPI

Sue Laveck, 5302022995

  • Pharmacist
  • Taylor, MI
National Provider Identifier
1972898674
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302022995 Issued in MI
Practice address
14099 Pardee Rd
T0280
Taylor, MI 48180-4792
Phone
(734) 288-0005
Fax
(734) 288-0005
NPI assigned
Jun 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302022995 MI Primary

Addresses

Primary practice location

14099 Pardee Rd
T0280
Taylor, MI 48180-4792

Mailing address

14099 Pardee Rd
T0280
Taylor, MI 48180-4792
Phone (734) 288-0005

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
5302022995MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1972898674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14099 PARDEE RD",
            "address_2": "T0280",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804792",
            "telephone_number": "734-288-0005",
            "fax_number": "734-288-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14099 PARDEE RD",
            "address_2": "T0280",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804792",
            "telephone_number": "734-288-0005",
            "fax_number": "734-288-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVECK",
        "first_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "5302022995",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302022995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.