Individual provider Active NPI

Kersten Wood, MSN, FNP-C

  • Family Nurse Practitioner
  • Port Huron, MI
National Provider Identifier
1164259651
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F09240424 Issued in MI
Practice address
1943 Holland Ave
Port Huron, MI 48060-1519
Phone
(810) 985-5700
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F09240424 MI Primary

Addresses

Primary practice location

1943 Holland Ave
Port Huron, MI 48060-1519

Mailing address

1315 Palmer CT
Port Huron, MI 48060-2086

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
I20241127000972 MI Practitioner - Nurse Practitioner 7810422854 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F09240424MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
George J Carley DO PC CurrentSince Oct 1, 2024 Accepting new patients

Locations

1943 Holland Ave
Port Huron, MI 48060
Phone (810) 982-5700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDHBCD/Endpoint/EDHBCD

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.

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1164259651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 PALMER CT",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1943 HOLLAND AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480601519",
            "telephone_number": "810-985-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KERSTEN",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F09240424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.