Individual provider Active NPI

Dorasy B Paul, RN, LLMSW

  • Registered Nurse
  • Ann Arbor, MI
National Provider Identifier
1164690723
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704276621 Issued in MI
Practice address
110 N 4TH Ave
Ann Arbor, MI 48104-5503
Phone
(734) 320-9717
Fax
(734) 222-3731
NPI assigned
Feb 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6802082200 MI
Registered Nurse 163W00000X 4704276621 MI Primary

Addresses

Primary practice location

110 N 4TH Ave
Ann Arbor, MI 48104-5503

Mailing address

110 N 4TH Ave
Ann Arbor, MI 48104-5503
Phone (734) 320-9717

Other identifiers 1

IdentifierTypeStateIssuer
XYP918050516OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN

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 Nurse

State licenses

LicenseStateTypeSpecialty
6802082200MIMDClinical Social Worker
4704276621MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of Washtenaw PastSince Jul 8, 2019 Accepting new patients
County of Washtenaw Past Accepting new patients

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": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1164690723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N 4TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045503",
            "telephone_number": "734-320-9717",
            "fax_number": "734-222-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 4TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045503",
            "telephone_number": "734-320-9717",
            "fax_number": "734-222-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "DORASY",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "RN, LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-18",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802082200",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704276621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "XYP918050516",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.