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1972530947 NPI number — BLUE CARE NETWORK OF MI

NPI Number: 1972530947
Health Care Provider/Practitioner: BLUE CARE NETWORK OF MI

Information about “1972530947” NPI (BLUE CARE NETWORK OF MI) exists in 1972530947 in HTML format HTML  |  1972530947 in plain Text format TXT  |  1972530947 in PDF (Portable Document Format) PDF  |  1972530947 in an XML format XML  formats.

NPI Number : 1972530947 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972530947",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BLUE CARE NETWORK OF MI",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "P O BOX 77000",
    "SecondLineMailingAddress": "DEPARTMENT 77251",
    "MailingAddressCityName": "DETROIT",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48277-0251",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "517-664-4727",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1525 W LAKE LANSING RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LANSING",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48823",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "517-664-4727",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/27/2006",
    "LastUpdateDate": "09/25/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LANIER",
    "AuthorizedOfficialFirstName": "DEREK",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "517-322-8007",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "4301060832",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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