Active NPI
Kirk Dahlstrom, RRT
- Registered Respiratory Therapist
- Detroit, MI
National Provider Identifier
1437551975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Respiratory Therapist
- License
- 4401004101
- Practice address
- 4646 John R St
Detroit, MI 48201-1916 - Phone
- (313) 576-1000
- Fax
- (313) 576-3723
- NPI assigned
- Sep 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Respiratory Therapist | 227900000X | 4401004101 | MI | Primary |
Addresses
Primary practice location
4646 John R St
Detroit, MI 48201-1916
Mailing address
4646 John R St
Detroit, MI 48201-1916
Phone (313) 576-1000
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 |
|---|---|---|---|
| 4401004101 | MI | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1437551975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-1000",
"fax_number": "313-576-3723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-1000",
"fax_number": "313-576-3723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHLSTROM",
"first_name": "KIRK",
"name_prefix": "Mr.",
"credential": "RRT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-16",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "227900000X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered",
"state": "MI",
"license": "4401004101",
"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 Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.