Individual provider Active NPI

Kennedy Bailey, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1235016346
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704374241 Issued in MI
Practice address
5716 Michigan Ave
Detroit, MI 48210-3039
Phone
(313) 554-1095
Fax
(313) 899-3560
NPI assigned
Aug 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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 4704374241 MI Primary

Addresses

Primary practice location

5716 Michigan Ave
Detroit, MI 48210-3039

Mailing address

559 W Grand Blvd
Detroit, MI 48216-2200
Phone (313) 554-0485

Other practice location 1

20901 Moross Rd
Detroit, MI 48236-2058
Phone (313) 626-2600

Other practice location 2

17625 Joy Rd
Detroit, MI 48228-1999
Phone (313) 446-8800

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
I20251112004179 MI Practitioner - Nurse Practitioner 1355832882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Michigan State University College of Human Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Community Care, Inc.Group PAC ID 1254393549, 17 clinicians

Practice addresses (Care Compare)

5716 Michigan Ave
Detroit, MI 48210-3039
Phone (313) 554-1095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704374241MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Community Care, Inc. CurrentSince Oct 28, 2025 Accepting new patients
Covenant Community Care, Inc. CurrentSince Oct 28, 2025 Accepting new patients

Locations

559 W Grand Blvd
Detroit, MI 48216
Phone (313) 554-0485

17625 Joy Rd
Detroit, MI 48228
Phone (313) 446-8800

5716 Michigan Ave
Detroit, MI 48210
Phone (313) 554-1095

20901 Moross Rd
Grosse Pointe, MI 48236
Phone (313) 626-2600

Interoperability endpoints

  • Direct secure messaging: kennedy.bailey.1@19800.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1235016346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482162200",
            "telephone_number": "313-554-0485",
            "fax_number": "313-228-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103039",
            "telephone_number": "313-554-1095",
            "fax_number": "313-899-3560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20901 Moross Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362058",
            "country_code": "US",
            "telephone_number": "313-626-2600",
            "fax_number": "313-626-2605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17625 Joy Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482281999",
            "country_code": "US",
            "telephone_number": "313-446-8800",
            "fax_number": "313-446-8810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KENNEDY",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704374241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.