Individual provider Active NPI

Desiree Harry

  • Personal Care Attendant
  • Davie, FL
National Provider Identifier
1548553449
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
12401 Orange Dr
Suite 219
Davie, FL 33330-4341
Phone
(954) 862-1707
NPI assigned
May 25, 2011
Last updated
May 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

12401 Orange Dr
Suite 219
Davie, FL 33330-4341

Mailing address

7927 Johnson St
Apt. 12
Pembroke Pines, FL 33024-6882
Phone (954) 534-6109

Other identifiers 1

IdentifierTypeStateIssuer
003135700MedicaidFL

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

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1548553449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7927 JOHNSON ST",
            "address_2": "APT. 12",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246882",
            "telephone_number": "954-534-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 ORANGE DR",
            "address_2": "SUITE 219",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304341",
            "telephone_number": "954-862-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRY",
        "first_name": "DESIREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.