Active NPI
Kristin M Emanuel, PHD
- Psychologist
- Saint Joseph, MI
National Provider Identifier
1225323280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301015211
- Practice address
- 3408 Niles Rd
Saint Joseph, MI 49085-8628 - Phone
- (692) 428-4789
- NPI assigned
- Jun 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301015211 | MI | Primary |
Addresses
Primary practice location
3408 Niles Rd
Saint Joseph, MI 49085-8628
Mailing address
3408 Niles Rd
Saint Joseph, MI 49085-8628
Phone (692) 428-4789
Other practice location 1
8333 Felch St
Zeeland, MI 49464-2608
Phone (616) 741-3790
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3573 Hollywood Rd
Saint Joseph, MI 49085-9581
Phone (269) 428-4789
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
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.
-
- Clinical Psychologist
- Saint Joseph, MI
- NPI 1326590928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1225323280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3408 NILES RD",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490858628",
"telephone_number": "692-428-4789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3408 NILES RD",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490858628",
"telephone_number": "692-428-4789"
}
],
"practiceLocations": [
{
"address_1": "8333 Felch St",
"address_purpose": "LOCATION",
"city": "Zeeland",
"state": "MI",
"postal_code": "494642608",
"country_code": "US",
"telephone_number": "616-741-3790",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EMANUEL",
"first_name": "KRISTIN",
"middle_name": "M",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-17",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301015211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.