Active NPI
Deshawn Melvin Radden, DPM
- Student in an Organized Health Care Education/Training Program
- Philadelphia, PA
National Provider Identifier
1982448940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- SC007444
- Practice address
- 10800 Knights Rd
Philadelphia, PA 19114-4200 - Phone
- (215) 612-5161
- NPI assigned
- Jun 24, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | SC007444 | PA | Primary |
Addresses
Primary practice location
10800 Knights Rd
Philadelphia, PA 19114-4200
Mailing address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-5161
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC007444 | PA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1982448940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10800 KNIGHTS RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191144200",
"telephone_number": "215-612-5161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10800 KNIGHTS RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191144200",
"telephone_number": "215-612-5161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADDEN",
"first_name": "DESHAWN",
"middle_name": "MELVIN",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-24",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "SC007444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.