Individual provider Active NPI

Terell Shanks

  • Adult Companion
  • Detroit, MI
National Provider Identifier
1871468009
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
12880 Dolphin St Apt 1
Detroit, MI 48223-3124
Phone
(248) 915-4513
NPI assigned
Oct 7, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult CompanionGroup: 193400000X SINGLE SPECIALTY GROUP 372600000X MI Primary

Addresses

Primary practice location

12880 Dolphin St Apt 1
Detroit, MI 48223-3124

Mailing address

24225 W 9 Mile Rd
Southfield, MI 48033-3962
Phone (248) 915-4513

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

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1871468009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24225 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333962",
            "telephone_number": "248-915-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12880 DOLPHIN ST APT 1",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482233124",
            "telephone_number": "248-915-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKS",
        "first_name": "TERELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Adult Companion",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.