Active NPI
Mark Kline
- Registered Nurse
- Southfield, MI
National Provider Identifier
1003362252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704285370
- Practice address
- 22170 W Nine Mile Rd
Southfield, MI 48033 - Phone
- (248) 372-6800
- NPI assigned
- Aug 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704285370 | MI | Primary |
Addresses
Primary practice location
22170 W Nine Mile Rd
Southfield, MI 48033
Mailing address
2399 E. Walton Blvd
Auburn Hills, MI 48326
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 |
|---|---|---|---|
| 4704285370 | MI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488412800000",
"number": "1003362252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2399 E. WALTON BLVD",
"city": "AUBURN HILLS",
"state": "MI",
"postal_code": "48326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22170 W NINE MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48033",
"telephone_number": "248-372-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINE",
"first_name": "MARK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-28",
"last_updated": "2017-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704285370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.