Active NPI
Kristi Vander Hyde, NP
- Primary Care Nurse Practitioner
- Dexter, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 4704157442
- Practice address
- 7300 Dexter-Ann Arbor Rd
Dexter, MI 48130-8598 - Phone
- (734) 426-2796
- NPI assigned
- Jun 1, 2005
- Last updated
- Dec 31, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704157442 | MI | |
| Community Health Nurse Practitioner | 363LC1500X | 4704157442 | MI | |
| Primary Care Nurse Practitioner | 363LP2300X | 4704157442 | MI | Primary |
Addresses
Primary practice location
7300 Dexter-Ann Arbor Rd
Dexter, MI 48130-8598
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104702549 | Medicaid | MI | |
| 0860085 | Other | MI | BCBS OF MICHIGAN |
| 4851610 | Medicaid | MI |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704157442 | MI | MD | Community Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of Michigan | Nurse Practitioner | Current | Accepting new patients |
| Regents of the University of Michigan | Current | Accepting new patients |
Locations
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
207 Fletcher St
Ann Arbor, MI 48109
Phone (734) 764-8320
3621 S State St
#700
Ann Arbor, MI 48108
400 E Eisenhower Pkwy
Ste B
Ann Arbor, MI 48108
Phone (734) 232-2600
7300 Dexter Ann Arbor Rd
Dexter, MI 48130
Phone (734) 426-2796
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Nurse Practitioner
- Ann Arbor, MI
- NPI 1447275102
-
- Specialty Pharmacy
- Dexter, MI
- NPI 1952181919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451520000000",
"number": "1225030497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 DEXTER-ANN ARBOR RD",
"city": "DEXTER",
"state": "MI",
"postal_code": "481308598",
"telephone_number": "734-426-2796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDER HYDE",
"first_name": "KRISTI",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-01",
"last_updated": "2015-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704157442",
"primary": false
},
{
"code": "363LC1500X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Community Health",
"state": "MI",
"license": "4704157442",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MI",
"license": "4704157442",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104702549",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MICHIGAN",
"identifier": "0860085",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4851610",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dexter, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; 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.