Active NPI
Phaedra West, BSN
- Critical Care Medicine Registered Nurse
- Detroit, MI
National Provider Identifier
1881490787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 4704235829
- Practice address
- 4646 John R St
Detroit, MI 48201-1932 - Phone
- (313) 576-1490
- NPI assigned
- Feb 21, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 4704235829 | MI | Primary |
Addresses
Primary practice location
4646 John R St
Detroit, MI 48201-1932
Mailing address
17749 Lennane
Redford, MI 48240-2163
Phone (313) 980-1719
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
- Credentials
- Bachelor on Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704235829 | MI | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740096000000",
"number": "1881490787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17749 LENNANE",
"city": "REDFORD",
"state": "MI",
"postal_code": "482402163",
"telephone_number": "313-980-1719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011932",
"telephone_number": "313-576-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEST",
"first_name": "PHAEDRA",
"name_prefix": "Mrs.",
"credential": "BSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-21",
"last_updated": "2025-02-21",
"certification_date": "2025-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "MI",
"license": "4704235829",
"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 Feb 21, 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.