Individual provider Active NPI

Kathryn Hayter, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1114077823
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
4704133284 Issued in MI
Practice address
25664 Lahser Rd
Southfield, MI 48033-5810
Phone
(248) 358-7521
Fax
(248) 358-7522
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704133284 MI Primary

Addresses

Primary practice location

25664 Lahser Rd
Southfield, MI 48033-5810

Mailing address

25664 Lahser Rd
Southfield, MI 48033-5810
Phone (248) 358-7521

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
I20100616000364 MI Practitioner - Nurse Practitioner 7911037072 Reassigns benefits to 1 organization

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
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

39450 W 12 Mile Rd
Novi, MI 48377-3600
Phone (248) 344-6688

6525 2ND Ave
Detroit, MI 48202-3006
Phone (313) 972-4200

7800 W Outer Dr
Detroit, MI 48235-3461
Phone (313) 543-6200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Aug 1, 2000 Accepting new patients
Henry Ford Health System CurrentSince Aug 1, 2000 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

Interoperability endpoints

  • Direct secure messaging: khayter13124@direct.hfhs.org

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1114077823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25664 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480335810",
            "telephone_number": "248-358-7521",
            "fax_number": "248-358-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25664 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480335810",
            "telephone_number": "248-358-7521",
            "fax_number": "248-358-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYTER",
        "first_name": "KATHRYN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704133284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.