Individual provider Active NPI

Denise Kerr, RN,NP

  • Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1013931054
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704141108 Issued in MI
Practice address
16001 W 9 Mile Rd
Cath Lab
Southfield, MI 48075-4818
Phone
(248) 849-3924
Fax
(248) 849-2717
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 4704141108 MI
Nurse Practitioner 363L00000X 4704141108 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd
Cath Lab
Southfield, MI 48075-4818

Mailing address

25925 Telegraph Rd
#210
Southfield, MI 48034-2518
Phone (248) 746-3218

Other identifiers 1

IdentifierTypeStateIssuer
4704141108OtherMIREGISTERED NURSE

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)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704141108MIMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1013931054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25925 TELEGRAPH RD",
            "address_2": "#210",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342518",
            "telephone_number": "248-746-3218",
            "fax_number": "248-746-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "address_2": "CATH LAB",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3924",
            "fax_number": "248-849-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "DENISE",
        "credential": "RN,NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MI",
            "license": "4704141108",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704141108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "4704141108",
            "state": "MI"
        }
    ],
    "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 Feb 1, 2011; 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.