Active NPI
Jitendra C Desai, RPH
- Pharmacist
- Wayne, MI
National Provider Identifier
1053400481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302022333
- Practice address
- 4603 S Wayne Rd
Wayne, MI 48184-2310 - Phone
- (734) 728-6000
- Fax
- (734) 728-2400
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302022333 | MI | Primary |
Addresses
Primary practice location
4603 S Wayne Rd
Wayne, MI 48184-2310
Mailing address
4603 S Wayne Rd
Wayne, MI 48184-2310
Phone (734) 728-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302022333 | Other | MI | PHARMACIST LICENSE NUMBER |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302022333 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053400481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4603 S WAYNE RD",
"city": "WAYNE",
"state": "MI",
"postal_code": "481842310",
"telephone_number": "734-728-6000",
"fax_number": "734-728-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4603 S WAYNE RD",
"city": "WAYNE",
"state": "MI",
"postal_code": "481842310",
"telephone_number": "734-728-6000",
"fax_number": "734-728-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAI",
"first_name": "JITENDRA",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302022333",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE NUMBER",
"identifier": "5302022333",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.