Individual provider Active NPI

Donna M Reesman, NP

  • Nephrology Registered Nurse
  • Detroit, MI
National Provider Identifier
1366589269
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology Registered NurseTaxonomy code 163WN0300X
License
4704164903 Issued in MI
Practice address
22201 Moross Rd
Suite 150
Detroit, MI 48236-2169
Phone
(586) 247-4300
Fax
(586) 532-6496
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Registered Nurse 163WN0300X 4704164903 MI Primary

Addresses

Primary practice location

22201 Moross Rd
Suite 150
Detroit, MI 48236-2169

Mailing address

45640 Schoenherr Rd
Utica, MI 48315-6033
Phone (586) 247-4300

Other identifiers 1

IdentifierTypeStateIssuer
4704164903OtherMINURSE PRACTITONER

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704164903MIMDNephrology Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Springs Nephrology 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1366589269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45640 SCHOENHERR RD",
            "city": "UTICA",
            "state": "MI",
            "postal_code": "483156033",
            "telephone_number": "586-247-4300",
            "fax_number": "586-532-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "SUITE 150",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "586-247-4300",
            "fax_number": "586-532-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESMAN",
        "first_name": "DONNA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nephrology",
            "state": "MI",
            "license": "4704164903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITONER",
            "identifier": "4704164903",
            "state": "MI"
        }
    ],
    "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 Nov 1, 2012; 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.