Deswil Medical Group PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DESWIL MEDICAL GROUP PLLC

Doing business as

Arise Medical and Wellness

Practice address

15815 Franklin TRL SE Ste 501
Prior Lake, MN 55372-2076

Phone

(952) 522-6344

NPI assigned

Sep 7, 2023

Last updated

Sep 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nana Wilmot-Desouza, MDNPI 1396009247

Title

Ceo

Phone

(952) 522-6344

Specialties & licenses 1

Addresses

Other names 1

• Arise Medical and Wellness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nana A Wilmot-Desouza, M.D

  • Family Medicine Physician
  • Apple Valley, MN
  • NPI 1396009247
  NPD Authorized official

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1508642232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15815 FRANKLIN TRL SE STE 501",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15815 FRANKLIN TRL SE STE 501",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722076",
            "telephone_number": "952-522-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESWIL MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "WILMOT-DESOUZA",
        "authorized_official_first_name": "NANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-522-6344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arise Medical and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Kevin Dahlen, M.A.
• Carlene Therese Daley, COTA/L
• Erika Marie Davis, LMFT
• Lisa Anne Dawson-Clausen, O.D.
• DDS House Call, PLLC
• Brian Mark Devitt, D.C.
• Naa Yemoley Dodoo
• Domier Chiropractic, PLLC
• Brittany Ann Domier, D.C.
• Dr. Howard E. Olson PA

• Family Medicine Physician in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.