Individual provider Active NPI

Denise Farris

  • Personal Care Attendant
  • Romulus, MI
National Provider Identifier
1851790414
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
190326120033 Issued in MI
Practice address
10909 Hannan Rd
Romulus, MI 48174-1383
Phone
(734) 839-1000
NPI assigned
Aug 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X 190326120033 MI
Personal Care Attendant 3747P1801X 190326120033 MI Primary

Addresses

Primary practice location

10909 Hannan Rd
Romulus, MI 48174-1383

Mailing address

22240 Wyman St
Detroit, MI 48219-3869
Phone (313) 739-9517

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

LicenseStateTypeSpecialty
190326120033MIMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1851790414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22240 WYMAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193869",
            "telephone_number": "313-739-9517",
            "fax_number": "313-537-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10909 HANNAN RD",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481741383",
            "telephone_number": "734-839-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "MI",
            "license": "190326120033",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "MI",
            "license": "190326120033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romulus, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.