Active NPI
Kristen Marie Dessouki, NP
- Nurse Practitioner
- Redford, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704276440
- Practice address
- 17190 Lennane
Redford, MI 48240-2130 - Phone
- (313) 704-2954
- NPI assigned
- Sep 19, 2022
- Last updated
- May 19, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704276440 | MI | Primary |
Addresses
Primary practice location
17190 Lennane
Redford, MI 48240-2130
Mailing address
PO Box 18998
Belfast, ME 04915-4084
Phone (469) 803-3000
Other practice location 1
261 Mack Ave
Detroit, MI 48201-2417
Phone (313) 745-1203
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | URL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| VHS Physicians of Michigan | Current | Accepting new patients | |
| Above & Beyond Urgent Care PLLC | Current | Accepting new patients | |
| HMC Urgent Care Wayne PLLC | Current | Accepting new patients |
Locations
261 Mack Ave
Detroit, MI 48201
Phone (313) 745-1100
261 Mack Ave
Ste 210
Detroit, MI 48201
Phone (313) 745-7610
32413 Michigan Ave
Wayne, MI 48184
Phone (313) 663-9000
Interoperability endpoints
- kristen.dessouki.1@28492.direct.athenahealth.com
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.
-
- Urgent Care Clinic/Center
- Wayne, MI
- NPI 1255013553
-
dba DMC Medical Group
- Internal Medicine Physician
- Southfield, MI
- NPI 1073827101
-
- Urgent Care Clinic/Center
- Dearborn Heights, MI
- NPI 1679280507
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779148800000",
"number": "1700508512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18998",
"city": "BELFAST",
"state": "ME",
"postal_code": "049154084",
"telephone_number": "469-803-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17190 LENNANE",
"city": "REDFORD",
"state": "MI",
"postal_code": "482402130",
"telephone_number": "313-704-2954"
}
],
"practiceLocations": [
{
"address_1": "261 Mack Ave",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482012417",
"country_code": "US",
"telephone_number": "313-745-1203",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DESSOUKI",
"first_name": "KRISTEN",
"middle_name": "MARIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-19",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704276440",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "URL",
"affiliation": "N",
"address_1": "17190 Lennane",
"city": "Redford",
"state": "MI",
"country_code": "US",
"postal_code": "482402130",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Redford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.