Organization Active NPI

Desfit & Dance LLC

  • Athletic Trainer
  • Washington, DC
National Provider Identifier
1962075267
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Legal business name
DESFIT & DANCE LLC
Practice address
2636 Wade Rd SE
Washington, DC 20020-5906
Phone
(202) 425-4108
NPI assigned
Jul 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Ms. Destinie BrownleeNPI 1811455033
Title
Ceo/ Owner
Phone
(202) 908-8149

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2255A2300X Primary

Addresses

Primary practice location

2636 Wade Rd SE
Washington, DC 20020-5906

Mailing address

2604 Berkley St
Temple Hills, MD 20748-2830
Phone (202) 425-4108

Other identifiers 1

IdentifierTypeStateIssuer
011587613MedicaidMD

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": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1962075267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 BERKLEY ST",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207482830",
            "telephone_number": "202-425-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 WADE RD SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200205906",
            "telephone_number": "202-425-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESFIT & DANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "BROWNLEE",
        "authorized_official_first_name": "DESTINIE",
        "authorized_official_title_or_position": "CEO/ OWNER",
        "authorized_official_telephone_number": "202-908-8149",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011587613",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.

Verify at the official NPI Registry.