Active NPI
Richard James Dandy, CPRM
- Peer Specialist
- Detroit, MI
National Provider Identifier
1306352877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- M-00114
- Practice address
- 9044 La Salle Blvd
Detroit, MI 48206-2021 - Phone
- (313) 651-6688
- Fax
- (313) 894-7460
- NPI assigned
- Dec 20, 2017
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | M-00114 | MI | Primary |
Addresses
Primary practice location
9044 La Salle Blvd
Detroit, MI 48206-2021
Mailing address
9044 La Salle Blvd
Detroit, MI 48206-2021
Phone (313) 894-7400
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 |
|---|---|---|---|
| M-00114 | MI | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513728000000",
"number": "1306352877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9044 LA SALLE BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482062021",
"telephone_number": "313-894-7400",
"fax_number": "313-894-7460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9044 LA SALLE BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482062021",
"telephone_number": "313-651-6688",
"fax_number": "313-894-7460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANDY",
"first_name": "RICHARD",
"middle_name": "JAMES",
"credential": "CPRM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-20",
"last_updated": "2017-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "MI",
"license": "M-00114",
"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 Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.