Active NPI
Deandre Prior
- Adult Companion
- Warren, MI
National Provider Identifier
1881267987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 24048 Wedgewood Cir
Warren, MI 48091-5871 - Phone
- (517) 513-0044
- NPI assigned
- Jul 19, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | MI | Primary |
Addresses
Primary practice location
24048 Wedgewood Cir
Warren, MI 48091-5871
Mailing address
24048 Wedgewood Cir
Warren, MI 48091-5871
Phone (517) 513-0044
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Desktops | Direct |
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": "1626652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1881267987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24048 WEDGEWOOD CIR",
"city": "WARREN",
"state": "MI",
"postal_code": "480915871",
"telephone_number": "517-513-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24048 WEDGEWOOD CIR",
"city": "WARREN",
"state": "MI",
"postal_code": "480915871",
"telephone_number": "517-513-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIOR",
"first_name": "DEANDRE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-19",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Desktops",
"affiliation": "N",
"endpointDescription": "Tablets",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Soap URL",
"address_1": "24048 Wedgewood Cir",
"city": "Warren",
"state": "MI",
"country_code": "US",
"postal_code": "480915871",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.