Individual provider Active NPI

Odeta Fecani, PHARM.D.

  • Pharmacist
  • Detroit, MI
National Provider Identifier
1386778835
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302034017 Issued in MI
Practice address
15455 Gratiot Ave
Detroit, MI 48205-1374
Phone
(313) 372-7076
Fax
(313) 527-5217
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302034017 MI Primary

Addresses

Primary practice location

15455 Gratiot Ave
Detroit, MI 48205-1374

Mailing address

25885 Village Green Blvd
Apt. 312
Harrison TWP, MI 48045-3054
Phone (586) 610-4064

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302034017MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386778835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25885 VILLAGE GREEN BLVD",
            "address_2": "APT. 312",
            "city": "HARRISON TWP",
            "state": "MI",
            "postal_code": "480453054",
            "telephone_number": "586-610-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15455 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051374",
            "telephone_number": "313-372-7076",
            "fax_number": "313-527-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FECANI",
        "first_name": "ODETA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302034017",
            "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 Jul 8, 2007; 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.