Kaitlin Marie Perdew, NP

Key facts

NPI

1134734890

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

4704292167 (MI)

Practice address

14650 E Old US Hwy 12
Chelsea, MI 48118-1801

Phone

(517) 414-6935

NPI assigned

Sep 10, 2020

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Spring Arbor University Family Medicine Physician · Spring Arbor, MI · NPI 1821347741
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kperdew866682@direct.hfhs.org

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 10, 2020.

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1134734890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 SNOWDRIFT PASS",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019732",
            "telephone_number": "517-414-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 E OLD US HWY 12",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181801",
            "telephone_number": "517-414-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDEW",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704292167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kaitlin.perdew@stjoeshealth.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "14650 E Old US Hwy 12",
            "city": "Chelsea",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481181801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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