Kyle M Farr, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704253005 Issued in MI

Practice address

640 Starkweather St Ste C
Plymouth, MI 48170-1371

Phone

(734) 259-2804

Fax

(734) 259-2805

NPI assigned

Jul 28, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1144508904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 TRADITION DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875808",
            "telephone_number": "269-352-8031",
            "fax_number": "734-259-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 STARKWEATHER ST STE C",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701371",
            "telephone_number": "734-259-2804",
            "fax_number": "734-259-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARR",
        "first_name": "KYLE",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-28",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704253005",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704253005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12304421",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Faoro, OTR
• Julie Fargo, SLP-CF
• Sabrina Farmer
• Joshua Faro
• Sadia Farooqui
• Robert Alan Farrell
• Victoria Farrington
• Carley Farrugia
• Sara Fathi, DDS
• Maggie Fauser

• Nurse Practitioner in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.

Verify at the official NPI Registry.