Active NPI
Molly Kidner, FNP-BC
- Family Nurse Practitioner
- Traverse City, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704183474
- Practice address
- 4062 W Royal Dr
Traverse City, MI 49684-8965 - Phone
- (231) 935-0338
- NPI assigned
- Dec 31, 2013
- Last updated
- Oct 28, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704183474 | MI | Primary |
Addresses
Primary practice location
4062 W Royal Dr
Traverse City, MI 49684-8965
Mailing address
4062 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 935-0338
Other practice location 1
829 N Center Ave Ste 210
Gaylord, MI 49735-1599
Phone (231) 935-0338
Other practice location 2
419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7777
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704183474 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalkaska Memorial Health Center | Family | Current | Accepting new patients |
| Munson Medical Center | Current | Accepting new patients | |
| Kalkaska Memorial Health Center | Current | Accepting new patients | |
| Munson Medical Center | Current | Accepting new patients | |
| Kalkaska Memorial Health Center | Nurse Practitioner | Current | Accepting new patients |
| Munson Medical Center | Current | Accepting new patients | |
| Munson Medical Group | Past | Accepting new patients | |
| Munson Medical Center | Past | Accepting new patients |
Locations
2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031
400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200
829 N Center Ave
Ste 210
Gaylord, MI 49735
Phone (989) 731-7860
419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500
1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000
3537 W Front St
Ste A
Traverse City, MI 49684
Phone (231) 935-2525
4062 W Royal Dr
Traverse City, MI 49684
Phone (231) 935-0338
Interoperability endpoints
- mkidner@direct.mhc.net
Organizations & group practices 8
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.
-
- Family Medicine Physician
- Kalkaska, MI
- NPI 1013183060
-
dba Endocrinology and Metabolism
- Endocrinology, Diabetes & Metabolism Physician
- Traverse City, MI
- NPI 1083761860
-
- Skilled Nursing Facility
- Kalkaska, MI
- NPI 1164386652
-
- Rural Health Clinic/Center
- Kalkaska, MI
- NPI 1306968102
Nurse Practitioner
-
dba Munson Healthcare Kidney and Hypertension Specialists
- Nephrology Physician
- Traverse City, MI
- NPI 1245314541
-
- Psychiatric Hospital Unit
- Traverse City, MI
- NPI 1891586103
-
dba Urgent Care-UCN
- Family Medicine Physician
- Traverse City, MI
- NPI 1881623031
-
dba Traverse Heart and Vascular
- Cardiovascular Disease Physician
- Traverse City, MI
- NPI 1821398322
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Kalkaska, MI
- NPI 1497751309
-
- Rural Acute Care Hospital
- Grayling, MI
- NPI 1083010953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1083035521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4062 W ROYAL DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496848965",
"telephone_number": "231-935-0338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4062 W ROYAL DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496848965",
"telephone_number": "231-935-0338"
}
],
"practiceLocations": [
{
"address_1": "829 N Center Ave Ste 210",
"address_purpose": "LOCATION",
"city": "Gaylord",
"state": "MI",
"postal_code": "497351599",
"country_code": "US",
"telephone_number": "231-935-0338",
"fax_number": "231-935-0569",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "419 S Coral St",
"address_purpose": "LOCATION",
"city": "Kalkaska",
"state": "MI",
"postal_code": "496462503",
"country_code": "US",
"telephone_number": "231-258-7777",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIDNER",
"first_name": "MOLLY",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-31",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704183474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.