Kaitlin Dughlas, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704338496 Issued in MI

Practice address

15350 Trenton Rd
Southgate, MI 48195-2027

Phone

(734) 283-4616

NPI assigned

Dec 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kwlodkowski423968@direct.hfhs.org
• Direct secure messaging: kaitlin.dughlas.1@33161.direct.athenahealth.com

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.

• Child and Adolescent Center P C

  • Pediatrics Physician
  • Southgate, MI
  • NPI 1952498875
  NPD (past)

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1093475154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15115 LEROY ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952618",
            "telephone_number": "734-771-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 TRENTON RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952027",
            "telephone_number": "734-283-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGHLAS",
        "first_name": "KAITLIN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704338496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Scott Dubois, DDS
• Nicole Michele Duckwyler-Tucker, LLMSW
• Julia Allison Dudewicz, MA, LPC
• Christi Marie Dufour
• Megan Dufour
• Alesha Duncan
• Dijuawne Dunlap
• Jonathan Alan Dunwoody Sr.
• Dione Durham
• Shannon Dusute

• Pediatric Nurse Practitioner in Southgate, MI
• Providers in Southgate, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.