Organization Active NPI

Nod-Prime Rheumatology Specialists PLLC

  • Nephrology Physician
  • Wyandotte, MI
National Provider Identifier
1811650435
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NOD-PRIME RHEUMATOLOGY SPECIALISTS PLLC
Practice address
1623 Ford Ave
Wyandotte, MI 48192-2303
Phone
(734) 389-7167
NPI assigned
Oct 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Brandi Conner
Title
Evp
Phone
(602) 714-8162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1623 Ford Ave
Wyandotte, MI 48192-2303

Mailing address

2375 E Camelback Rd Ste 600
Phoenix, AZ 85016-3493
Phone (602) 714-8162

Other identifiers 1

IdentifierTypeStateIssuer
5357970MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1811650435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 E CAMELBACK RD STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163493",
            "telephone_number": "602-714-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922303",
            "telephone_number": "734-389-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOD-PRIME RHEUMATOLOGY SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-20",
        "last_updated": "2025-09-11",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "602-714-8162"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5357970",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.