Individual provider Active NPI

Kathleen F. Webber, CPNP

  • Pediatric Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1023047594
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704271044 Issued in MI
Practice address
3950 Beaubien
Children'S Specialty Clinic
Detroit, MI 48201-2169
Phone
(202) 253-9525
Fax
(313) 966-7478
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704271044 MI Primary

Addresses

Primary practice location

3950 Beaubien
Children'S Specialty Clinic
Detroit, MI 48201-2169

Mailing address

34 Newberry PL
Grosse Pointe Farms, MI 48236-3750
Phone (202) 253-9525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180103002685 MI Practitioner - Nurse Practitioner 8729346390 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704271044MIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Health Corporation of Southeastern Michigan CurrentSince Nov 29, 2017 Accepting new patients
Seton Health Corporation of Southeastern Michigan CurrentSince Nov 29, 2017 Accepting new patients
University Pediatricians CurrentSince Jul 12, 2023 Accepting new patients
University Pediatricians CurrentSince Jul 12, 2023 Accepting new patients
Bloom Pediatrics PC Past Accepting new patients

Locations

3950 Beaubien St
Detroit, MI 48201
Phone (313) 745-5437

4160 John R St
Ste 804
Detroit, MI 48201
Phone (313) 833-1271

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

22255 Greenfield Rd
Ste 550
Southfield, MI 48075
Phone (586) 226-6161

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1023047594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 NEWBERRY PL",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363750",
            "telephone_number": "202-253-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 BEAUBIEN",
            "address_2": "CHILDREN'S SPECIALTY CLINIC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012169",
            "telephone_number": "202-253-9525",
            "fax_number": "313-966-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBBER",
        "first_name": "KATHLEEN",
        "middle_name": "F.",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704271044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.