Individual provider Active NPI

Gail Frances Denuccio, D. O.

  • Family Medicine Physician
  • Westland, MI
National Provider Identifier
1669560959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101010228 Issued in MI
Practice address
6149 N Wayne Rd
Westland, MI 48185-7128
Phone
(734) 728-2130
Fax
(734) 728-2626
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101010228 MI Primary

Addresses

Primary practice location

6149 N Wayne Rd
Westland, MI 48185-7128

Mailing address

6149 N Wayne Rd
Westland, MI 48185-7128
Phone (734) 728-2130

Other identifiers 1

IdentifierTypeStateIssuer
4392034MedicaidMI

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101010228MIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669560959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6149 N WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481857128",
            "telephone_number": "734-728-2130",
            "fax_number": "734-728-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6149 N WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481857128",
            "telephone_number": "734-728-2130",
            "fax_number": "734-728-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENUCCIO",
        "first_name": "GAIL",
        "middle_name": "FRANCES",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101010228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4392034",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.