Individual provider Active NPI

Deanna Denny, RD

  • Registered Dietitian
  • Novi, MI
National Provider Identifier
1104291400
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1057872 Issued in MI
Practice address
23455 Haggerty Rd
Novi, MI 48375-3726
Phone
(248) 962-5201
NPI assigned
Dec 11, 2015
Reactivated
Jun 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1057872 MI Primary

Addresses

Primary practice location

23455 Haggerty Rd
Novi, MI 48375-3726

Mailing address

23455 Haggerty Rd
Novi, MI 48375-3726
Phone (248) 962-5201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240914000128 MI Practitioner - Registered Dietitian Or Nutrition Professional 1850831033 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1057872MIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways CurrentSince Sep 3, 2024 Accepting new patients

Locations

2500 7th Ave S
Escanaba, MI 49829
Phone (906) 786-2172

2500 7th Ave S
Ste 100
Escanaba, MI 49829
Phone (906) 233-1322

200 W Spring St
Marquette, MI 49855
Phone (906) 225-1181

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1104291400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23455 HAGGERTY RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753726",
            "telephone_number": "248-962-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23455 HAGGERTY RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753726",
            "telephone_number": "248-962-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNY",
        "first_name": "DEANNA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-11",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "deactivation_date": "2019-09-06",
        "reactivation_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "1057872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.