Active NPI
Nathan Dejohn
- Pharmacist
- Detroit, MI
National Provider Identifier
1154807287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302042411
- Practice address
- 10652 Gratiot Ave
Detroit, MI 48213-1200 - Phone
- (734) 655-0248
- NPI assigned
- Jul 11, 2018
- Last updated
- Mar 27, 2025
- Sex
- Male
- Sole proprietor
- No
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 | 5302042411 | MI | Primary |
Addresses
Primary practice location
10652 Gratiot Ave
Detroit, MI 48213-1200
Mailing address
10652 Gratiot Ave
Detroit, MI 48213-1200
Phone (734) 655-0248
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302042411 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| XRX, Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743033600000",
"number": "1154807287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10652 GRATIOT AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482131200",
"telephone_number": "734-655-0248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10652 GRATIOT AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482131200",
"telephone_number": "734-655-0248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEJOHN",
"first_name": "NATHAN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-11",
"last_updated": "2025-03-27",
"certification_date": "2025-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302042411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.