St Clair Adult Care PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301039079 Issued in MI

Legal business name

ST CLAIR ADULT CARE PC

Practice address

25932 Dequindre Rd
Ste. C
Warren, MI 48091-1071

Phone

(248) 859-6369

Fax

(586) 486-5552

NPI assigned

Sep 4, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Theodore Densley, M.D.

Title

Medical Director

Phone

(248) 859-6369

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1316315575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25932 DEQUINDRE RD",
            "address_2": "STE. C",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480911071",
            "telephone_number": "248-859-6369",
            "fax_number": "586-486-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25932 DEQUINDRE RD",
            "address_2": "STE. C",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480911071",
            "telephone_number": "248-859-6369",
            "fax_number": "586-486-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLAIR ADULT CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "DENSLEY",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-859-6369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301039079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SS Comfort Care Services LLC (Providing Various Health Care Services To People in Need)
• SS Medical Equipment, Inc.
• SSC Warren Operating Company LLC (Warren Woods Health and Rehabilitation Center)
• SSS Home Care LLC
• St Anthony Acquisition Company Inc (St Anthony Healthcare Center)
• St John Dynamic Spine Center
• St John Health System- Detroit-Macomb Campus
• St John Hospital and Medical Center
• St John Macomb Oakland Hospital
• St John Macomb Oakland Hospital

• Internal Medicine Physician in Warren, MI
• Providers in Warren, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.