Active NPI
Kianna Anderson, MSN, APRN, FNP-BC
- Family Nurse Practitioner
- Detroit, MI
National Provider Identifier
1053068320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704312785
- Practice address
- 17743 Northrop St
Detroit, MI 48219-2321 - Phone
- (313) 932-0146
- NPI assigned
- Mar 7, 2022
- Last updated
- Mar 7, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704312785 | MI | Primary |
Addresses
Primary practice location
17743 Northrop St
Detroit, MI 48219-2321
Mailing address
17743 Northrop St
Detroit, MI 48219-2321
Phone (313) 932-0146
Other names 1
- Kianna Whittington
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4055 Valley View LN
Suite 700
Dallas, TX 75244-4910
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704312785 | MI | MD | Family Nurse Practitioner |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646611200000",
"number": "1053068320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17743 NORTHROP ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482192321",
"telephone_number": "313-932-0146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17743 NORTHROP ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482192321",
"telephone_number": "313-932-0146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KIANNA",
"credential": "MSN, APRN, FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-07",
"last_updated": "2022-03-07",
"certification_date": "2022-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704312785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIANNA",
"last_name": "WHITTINGTON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.