Individual provider Active NPI

Kelly Hopper, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Flint, MI
National Provider Identifier
1164082285
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704283210 Issued in MI
Practice address
4800 S Saginaw St
Flint, MI 48507-2677
Phone
(810) 732-8336
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704283210 MI Primary

Addresses

Primary practice location

4800 S Saginaw St
Flint, MI 48507-2677

Mailing address

8123 Tipsico TRL
Holly, MI 48442-9144

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
I20190718001519 MI Practitioner - Nurse Practitioner 9335474980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jawad a Shah MD PCGroup PAC ID 5799779633, 89 clinicians

Practice addresses (Care Compare)

4800 S Saginaw St
Suite 1800
Flint, MI 48507-2677
Phone 8107329333116

Hospital & facility affiliations

  • McLaren Flint Hospital, Flint, MI, CCN 230141
  • Southeast Michigan Surgical Hospital LLC Hospital, Warren, MI, CCN 230264
  • Insight Hospital and Medical Center Coldwater Hospital, Coldwater, MI, CCN 230022
  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704283210MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jawad a Shah MD PC CurrentSince Jul 8, 2019 Accepting new patients
Jawad a Shah, MD PC CurrentSince Jul 8, 2019 Accepting new patients

Locations

5111 Auto Club Dr
Dearborn, MI 48126
Phone (313) 317-2000

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

21230 Dequindre Rd
Warren, MI 48091
Phone (586) 427-1000

30800 Van Dyke Ave
Warren, MI 48093
Phone 8102759333116

Interoperability endpoints

  • Direct secure messaging: khopper1132476@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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1164082285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8123 TIPSICO TRL",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484429144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S SAGINAW ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072677",
            "telephone_number": "810-732-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPPER",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704283210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.