Active NPI
Kimberly K Monroe, M.D.
- Pediatrics Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301096296
- Practice address
- 1500 E Medical Center Drive
12TH Floor CS Mott Childrens Hospital Room 525
Ann Arbor, MI 48109-4280 - Phone
- (734) 763-5302
- NPI assigned
- Sep 8, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036-108058 | IL | |
| Pediatrics Physician | 208000000X | 4301096296 | MI | Primary |
Addresses
Primary practice location
1500 E Medical Center Drive
12TH Floor CS Mott Childrens Hospital Room 525
Ann Arbor, MI 48109-4280
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036108058 | Medicaid | IL |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-108058 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward W Sparrow Hospital Association | Current | Accepting new patients | |
| Regents of the University of Michigan | Current | Accepting new patients | |
| Edward W. Sparrow Hospital Association | Pediatrics | Current | Accepting new patients |
| W.a. Foote Memorial Hospital, Inc | Current | Accepting new patients | |
| Edward W. Sparrow Hospital Association | Pediatrics | Current | Accepting new patients |
| Regents of the University of Michigan | Pediatrics | Current | Accepting new patients |
| Regents of the University of Michigan | Pediatrics | Current | Accepting new patients |
| Wa Foote Memorial Hospital, Inc | Current | Accepting new patients |
Locations
8175 Reliable Pkwy
Chicago, IL 60686
1500 E Medical Center Dr
Fl 12
Ann Arbor, MI 48109
Phone (734) 615-7845
1500 E Medical Center Dr
Fl 6
Ann Arbor, MI 48109
Phone (734) 764-5302
3621 S State St
#700
Ann Arbor, MI 48108
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
1200 E Michigan Ave
Ste 460
Lansing, MI 48912
Phone (517) 364-2097
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Lansing, MI
- NPI 1831139088
-
- Internal Medicine Physician
- Ann Arbor, MI
- NPI 1205868353
Pediatrics
-
- Internal Medicine Physician
- Jackson, MI
- NPI 1831123728
-
- Adult Health Nurse Practitioner
- Lansing, MI
- NPI 1265220438
-
- Pediatrics Physician
- Lansing, MI
- NPI 1720034499
-
- Developmental - Behavioral Pediatrics Physician
- Ann Arbor, MI
- NPI 1114950656
-
- Specialty Pharmacy
- Dexter, MI
- NPI 1952181919
-
- Physician Assistant
- Jackson, MI
- NPI 1538606348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1124012984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DRIVE",
"address_2": "12TH FLOOR CS MOTT CHILDRENS HOSPITAL ROOM 525",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481094280",
"telephone_number": "734-763-5302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONROE",
"first_name": "KIMBERLY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-08",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036-108058",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301096296",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036108058",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.