Active NPI
Deidre Y Cannon
- Phlebotomy Technician
- Farmington Hills, MI
National Provider Identifier
1164147799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- Practice address
- 31839 Kingswood Square
Farmington Hills, MI 48334 - Phone
- (248) 836-7520
- NPI assigned
- Oct 6, 2022
- Last updated
- Oct 6, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | Primary |
Addresses
Primary practice location
31839 Kingswood Square
Farmington Hills, MI 48334
Mailing address
6689 Orchard Lake Rd Unit 142
West Bloomfield, MI 48322-3404
Phone (248) 836-7520
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1164147799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6689 ORCHARD LAKE RD UNIT 142",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223404",
"telephone_number": "248-836-7520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31839 KINGSWOOD SQUARE",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "48334",
"telephone_number": "248-836-7520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "DEIDRE",
"middle_name": "Y",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-06",
"last_updated": "2022-10-06",
"certification_date": "2022-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.