Individual provider Active NPI

Deniene King, NP-C

  • Adult Health Nurse Practitioner
  • Oak Park, MI
National Provider Identifier
1093107948
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AG0215066 Issued in MI
Practice address
23300 Greenfield Rd
#203
Oak Park, MI 48237-5237
Phone
(248) 968-1550
NPI assigned
Mar 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AG0215066 MI Primary
Gerontology Nurse Practitioner 363LG0600X AG0215066 MI

Addresses

Primary practice location

23300 Greenfield Rd
#203
Oak Park, MI 48237-5237

Mailing address

23300 Greenfield Rd
#203
Oak Park, MI 48237-5237
Phone (248) 968-1550

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
I20151112001155 MI Practitioner - Nurse Practitioner 1153631692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Huron Valley Consultation Center IncGroup PAC ID 5698761161, 16 clinicians

Practice addresses (Care Compare)

2750 S State St
Ann Arbor, MI 48104-6179
Phone (734) 662-6300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG0215066MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Muksi, LLC CurrentSince Jun 9, 2016 Accepting new patients
Huron Valley Consultation Center Inc CurrentSince Nov 10, 2016 Accepting new patients

Locations

2750 S State St
Ann Arbor, MI 48104
Phone (734) 662-1986

26631 Southfield Rd
Lathrup Village, MI 48076
Phone (248) 552-8195

26411 Southfield Rd
Lathrup Village, MI 48076
Phone (248) 424-8000

Organizations & group practices 2

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": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1093107948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23300 GREENFIELD RD",
            "address_2": "#203",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482375237",
            "telephone_number": "248-968-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23300 GREENFIELD RD",
            "address_2": "#203",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482375237",
            "telephone_number": "248-968-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "DENIENE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "AG0215066",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "AG0215066",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

Verify at the official NPI Registry.