Active NPI
Kelly Hopper, AGACNP-BC
- Acute Care Nurse Practitioner
- Flint, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 4704283210
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
Practice addresses (Care Compare)
4800 S Saginaw St
Suite 1800
Flint, MI 48507-2677
Phone 8107329333116
Hospital & facility affiliations
- McLaren Flint
- Southeast Michigan Surgical Hospital LLC
- Insight Hospital and Medical Center Coldwater
- Ascension Genesys Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704283210 | MI | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jawad a Shah MD PC | Current | Accepting new patients | |
| Jawad a Shah, MD PC | Current | 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
- 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.
-
- Specialist
- Flint, MI
- NPI 1942402391
-
- Durable Medical Equipment & Medical Supplies
- Dearborn, MI
- NPI 1114667763
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Coldwater, MI
- NPI 1063471639
-
- General Acute Care Hospital
- Grand Blanc, MI
- NPI 1407877723
-
- General Acute Care Hospital
- Flint, MI
- NPI 1902894512
-
- General Acute Care Hospital
- Warren, MI
- NPI 1962402354
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.