1740679380 NPI number — WINDELL DWAYNE FORD M.A., N.A

NPI Number: 1740679380
Health Care Provider/Practitioner: WINDELL DWAYNE FORD M.A., N.A

NPI Number : 1740679380 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740679380",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FORD",
    "FirstName": "WINDELL",
    "MiddleName": "DWAYNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.A., N.A",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "26150 5 MILE RD STE 31",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "REDFORD",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48239-3240",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "26150 5 MILE RD STE 31",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "REDFORD",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48239-3240",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "313-740-7364",
    "PracticeLocationAddressFaxNumber": "313-740-7364",
    "EnumerationDate": "01/20/2015",
    "LastUpdateDate": "01/20/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "246RP1900X",
          "TaxonomyName": "Phlebotomy Technician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "372500000X",
          "TaxonomyName": "Chore Provider",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "372600000X",
          "TaxonomyName": "Adult Companion",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "374U00000X",
          "TaxonomyName": "Home Health Aide",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "376J00000X",
          "TaxonomyName": "Homemaker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "376K00000X",
          "TaxonomyName": "Nurse's Aide",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}