Desir Medical LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DESIR MEDICAL LLC

Practice address

6683 Cottonwood KNL
W Bloomfield, MI 48322-3843

Phone

(313) 720-4254

NPI assigned

Jul 2, 2021

Last updated

Nov 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thierry M DesirNPI 1063531960

Title

Owner

Phone

(313) 720-4254

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thierry Desir, PA-C

  • Physician Assistant
  • Detroit, MI
  • NPI 1063531960
  Medicare reassignment Authorized official
• Anthony W Clarke, M.D.

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1811055858
  Medicare reassignment NPD
• Rachel E Redman, CNP

  • Nurse Practitioner
  • Adrian, MI
  • NPI 1023763471
  Medicare reassignment NPD

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1982275723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6683 COTTONWOOD KNL",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6683 COTTONWOOD KNL",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223843",
            "telephone_number": "313-720-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIR MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "DESIR",
        "authorized_official_first_name": "THIERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-720-4254"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Coxx, LLC
• Kyrras Ayryk Conrad, RN
• Karen Copeland, LMSW
• Tyrus Curtis, MSW
• Leslie Ivan Denes, O.D.
• DMC Billing Associates LLC
• Diane Dupree
• Extended Care Medical Assoc. PC
• Alonda Fletcher, LMSW
• Susan Gayer, MSW

• Clinic/Center in W Bloomfield, MI
• Providers in W Bloomfield, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.