Individual provider Active NPI

Danielle Michel Smith, NP

  • Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1669450748
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704194031 Issued in MI
Practice address
18101 Oakwood Blvd
Isu-Obs
Dearborn, MI 48123-4089
Phone
(313) 982-5770
Fax
(313) 982-5771
NPI assigned
Jan 9, 2006
Last updated
Sep 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704194031 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Isu-Obs
Dearborn, MI 48123-4089

Mailing address

23300 Ecorse Rd
Taylor, MI 48180-1768
Phone (313) 291-9500

Other identifiers 7

IdentifierTypeStateIssuer
10-4559040MedicaidMI
10-4636630MedicaidMI
10-4559012MedicaidMI
10-4559059MedicaidMI
11712584OtherCAQH
10-4559021MedicaidMI
10-4559030MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040220000946 MI Practitioner - Nurse Practitioner 1456246008 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Future Comprehensive Care, P.C. CurrentSince Aug 1, 2019 Accepting new patients
Comprehensive Hospital Care P C CurrentSince Nov 1, 2017 Accepting new patients
Satinder Kumar Aggarwal MD P C Past Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

23300 Ecorse Rd
Taylor, MI 48180
Phone (313) 291-9500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1669450748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23300 ECORSE RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481801768",
            "telephone_number": "313-291-9500",
            "fax_number": "313-291-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "address_2": "ISU-OBS",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481234089",
            "telephone_number": "313-982-5770",
            "fax_number": "313-982-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIELLE",
        "middle_name": "MICHEL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704194031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10-4559040",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10-4636630",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10-4559012",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10-4559059",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11712584",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10-4559021",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10-4559030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.