Individual provider Active NPI

Connie Marie Durso-Watkins

  • Case Manager/Care Coordinator
  • Clinton Township, MI
National Provider Identifier
1558880880
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
42669 Garfield Rd
Clinton Township, MI 48038-1653
Phone
(586) 412-5312
NPI assigned
Sep 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

42669 Garfield Rd
Clinton Township, MI 48038-1653

Mailing address

6549 Town Center Dr Ste a
Clarkston, MI 48346-4824
Phone (248) 620-6400

Other practice location 1

41521 W 11 Mile Rd
Novi, MI 48375-1803
Phone (248) 912-1566

Other practice location 2

15930 19 Mile Rd Ste 150
Clinton Twp, MI 48038-1155
Phone (586) 464-0175

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ellie Sem Clinic, PLLC PastSince Dec 6, 2022 Accepting new patients
Macomb Oakland Regional Center Inc. Past Accepting new patients

Organizations & group practices 2

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1558880880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "248-620-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42669 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381653",
            "telephone_number": "586-412-5312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41521 W 11 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751803",
            "country_code": "US",
            "telephone_number": "248-912-1566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15930 19 Mile Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Clinton Twp",
            "state": "MI",
            "postal_code": "480381155",
            "country_code": "US",
            "telephone_number": "586-464-0175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURSO-WATKINS",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.