Active NPI
Sharlene K Kennedy, N. P.
- Family Nurse Practitioner
- Flint, MI
National Provider Identifier
1194876920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704088180
- Practice address
- One Hurley Plaza
Nursing Administration
Flint, MI 48503 - Phone
- (810) 257-9526
- Fax
- (810) 257-9471
- NPI assigned
- Jan 16, 2007
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704088180 | MI | Primary |
Addresses
Primary practice location
One Hurley Plaza
Nursing Administration
Flint, MI 48503
Mailing address
1085 S Linden Rd
Suite 150
Flint, MI 48532-3421
Phone (810) 732-3240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4291971 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704088180 | MI | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1194876920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1085 S LINDEN RD",
"address_2": "SUITE 150",
"city": "FLINT",
"state": "MI",
"postal_code": "485323421",
"telephone_number": "810-732-3240",
"fax_number": "810-230-0280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE HURLEY PLAZA",
"address_2": "NURSING ADMINISTRATION",
"city": "FLINT",
"state": "MI",
"postal_code": "48503",
"telephone_number": "810-257-9526",
"fax_number": "810-257-9471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "SHARLENE",
"middle_name": "K",
"credential": "N. P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704088180",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4291971",
"state": "MI"
}
],
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.