Individual provider Active NPI

Denika Leflora Dalton, NP-C

  • Gerontology Nurse Practitioner
  • Grand Blanc, MI
National Provider Identifier
1124644661
Registry record updated Jun 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704277539 Issued in MI
Practice address
5260 Fairway TRL
Grand Blanc, MI 48439-9445
Phone
(810) 610-7175
NPI assigned
Jun 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704277539 MI Primary

Addresses

Primary practice location

5260 Fairway TRL
Grand Blanc, MI 48439-9445

Mailing address

5260 Fairway TRL
Grand Blanc, MI 48439-9445
Phone (810) 610-7175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713003125 MI Practitioner - Nurse Practitioner 5597167551 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704277539MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Jul 5, 2023 Accepting new patients
Life in 3D Health Services Current Accepting new patients

Locations

2425 Austins Pkwy
Ste 3
Flint, MI 48507
Phone (810) 322-1948

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: ddalton39128@direct.hurleymc.com

Organizations & group practices 2

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": "1592697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592697600000",
    "number": "1124644661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5260 FAIRWAY TRL",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484399445",
            "telephone_number": "810-610-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5260 FAIRWAY TRL",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484399445",
            "telephone_number": "810-610-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "DENIKA",
        "middle_name": "LEFLORA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-21",
        "last_updated": "2020-06-21",
        "certification_date": "2020-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704277539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.