Active NPI
Paul Armand Desilets
- Home Modifications Contractor
- Fredericksburg, VA
National Provider Identifier
1760635130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- 2705 125500
- Practice address
- 11615 New Bond St
Fredericksburg, VA 22408-1864 - Phone
- (540) 891-9565
- NPI assigned
- Oct 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 2705 125500 | VA | Primary |
Addresses
Primary practice location
11615 New Bond St
Fredericksburg, VA 22408-1864
Mailing address
11615 New Bond St
Fredericksburg, VA 22408-1864
Phone (540) 891-9565
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2705 125500 | VA | MD | Home Modifications Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pad Renovations | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Customized Equipment (DME)
- Fredericksburg, VA
- NPI 1376955799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1760635130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11615 NEW BOND ST",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224081864",
"telephone_number": "540-891-9565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11615 NEW BOND ST",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224081864",
"telephone_number": "540-891-9565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESILETS",
"first_name": "PAUL",
"middle_name": "ARMAND",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-29",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "VA",
"license": "2705 125500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.