MR. LARRY SCOTT FITZGERALD (NPI# 1427660596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427660596 |
| Entity Type | Individual |
| Full Name | MR. LARRY SCOTT FITZGERALD |
| Credential | RN |
| Practice Address |
43825 Michigan Ave Ste 1 Canton MI 48188-2551 |
| Mailing Address |
37450 Schoolcraft Rd Ste 110 Livonia MI 48150-1000 |
| Practice Telephone | 7343313088 |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
4724201358 | MI | Nursing Service Providers |
| Street Address |
43825 MICHIGAN AVE STE 1 |
| City | CANTON |
| State | MI |
| Zip Code | 48188-2551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578963716 | Tanya Ann Bishop-chinchilla | Social Worker | 43825 Michigan Ave Ste 1, Canton, MI 48188-2551 | 2014-08-25 |
| 1407491368 | Amber M Dillon | Social Worker | 43825 Michigan Ave Ste 1, Canton, MI 48188-2551 | 2019-11-14 |
| 1598318982 | Yasmine Ghassani | Counselor | 43825 Michigan Ave Ste 1, Canton, MI 48188-2551 | 2019-07-24 |
| 1124688569 | Kristy Joy Anderson | Licensed Practical Nurse | 43825 Michigan Ave Ste 1, Canton, MI 48188-2551 | 2019-06-18 |
| 1609376938 | Michele Lynn Hufnagel | Counselor | 43825 Michigan Ave Ste 1, Canton, MI 48188-2551 | 2018-02-13 |
| 1942724877 | Annette Corradi | Counselor | 43825 Michigan Ave Ste 1, Canton, MI 48188-2551 | 2017-08-02 |
| 1194252270 | Scott Herron | Counselor | 43825 Michigan Ave Ste 1, Canton, MI 48188-2551 | 2017-05-19 |
| 1225570500 | Yvonne Walker | Licensed Practical Nurse | 43825 Michigan Ave Ste 1, Canton, MI 48188-2551 | 2016-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766425 | Kesha Glimps | Home Health Aide | 513 Cherry Orchard, Canton, MI 48188 | 2020-09-24 |
| 1881222578 | Darlenda Knuckles | Licensed Practical Nurse | 43825 Michigan Ave, Canton, Mi 48188, Canton, MI 48188 | 2020-03-30 |
| 1023646049 | Nikeyta Catrice Evans | Licensed Practical Nurse | 43825 Michign Ave Suite 2, Canton, MI 48188 | 2020-03-27 |
| 1013473925 | Yen Do Ruiz | Pharmacist | 41460 Haggerty Circle South, Canton, MI 48188 | 2019-02-15 |
| 1366938607 | Abidi Mehdi Medical, Pllc | Internal Medicine | 44237 Michigan Avenue, Canton, MI 48188 | 2018-07-10 |
| 1720589427 | Audrey Imbur | Physical Therapist | 4111 S. Canton Center Rd, Canton, MI 48188 | 2018-02-27 |
| 1639687700 | Tanveer Hussain | Physical Therapist | 3439 Brooklyn Dr, Canton, MI 48188 | 2018-01-11 |
| 1376054833 | Cherry Hill Village Pharmacy LLC | Pharmacy | 50429 Independence St, Canton, MI 48188 | 2017-10-23 |
| 1396262101 | Enid Alexandra Moore | Social Worker | 40946 Crossbow Cir, Apt 201, Canton, MI 48188 | 2017-08-23 |
| 1922520865 | Marc Slotnick | Peer Specialist | 43825 Michigan Ave., Canton, MI 48188 | 2017-07-12 |
| Find all providers in zip 48188 | ||||
| Taxonomy Code | 163WA0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049215 | Molly Rose Kathleen Davis | Registered Nurse | 2600 6th St Sw, Canton, OH 44710-1702 | 2020-10-05 |
| 1932711652 | Renee N/a Pollard | Registered Nurse | 43825 Michigan Ave, Canton, MI 48188-2551 | 2020-08-24 |
| 1932734167 | Bonny Jeanne Jarvis | Registered Nurse | 2600 6th St Sw, Canton, OH 44710-1702 | 2020-03-09 |
| 1013568633 | Vanessa Lynn Sanders | Registered Nurse | 43825 Michigan Ave, Canton, MI 48188-2551 | 2019-09-25 |
| 1184163669 | Karla Monte | Registered Nurse | 625 Cleveland Ave Nw, Canton, OH 44702-1805 | 2017-02-17 |
| 1215383872 | Karen Maxon | Registered Nurse | 1341 Market Ave N, Canton, OH 44714-2605 | 2016-05-12 |
| 1629438700 | Kathleen Coladonato | Registered Nurse | 1341 Market Ave N, Canton, OH 44714-2605 | 2016-03-02 |
| 1477912582 | Kathleen Tawney | Registered Nurse | 1341 Market Ave N, Canton, OH 44714-2605 | 2016-02-17 |
| 1861870727 | Terrie Batdorff | Registered Nurse | 1341 Market Ave N, Canton, OH 44714-2605 | 2015-05-12 |
| 1326426289 | Ronda Lytsell | Registered Nurse | 1341 Market Ave N, Canton, OH 44714-2605 | 2015-05-12 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.