Individual provider Active NPI

Ariane Kennedy

  • Adult Health Nurse Practitioner
  • Sterling Heights, MI
National Provider Identifier
1255976288
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704266121 Issued in MI
Practice address
8244 Metro Pkwy Ste C
Sterling Heights, MI 48312-2778
Phone
(586) 795-4060
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704266121 MI
Adult Health Nurse Practitioner 363LA2200X 4704266121 MI Primary

Addresses

Primary practice location

8244 Metro Pkwy Ste C
Sterling Heights, MI 48312-2778

Mailing address

53423 Jaclyn Dr
Shelby Township, MI 48315-1821

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
I20200610002649 MI Practitioner - Nurse Practitioner 5890116230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Medical Associates PCGroup PAC ID 2860743309, 23 clinicians

Practice addresses (Care Compare)

27560 Hoover Rd
Warren, MI 48093-4505
Phone (586) 573-5890

Hospital & facility affiliations

  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704266121MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paramount Medical Group PC Current Accepting new patients
Pioneer Medical Associates P.C. Nurse Practitioner CurrentSince Jan 1, 2023 Accepting new patients
Pioneer Endoscopy & Surgery Center, L.L.C. CurrentSince Jan 1, 2023 Accepting new patients

Locations

27560 Hoover Rd
Warren, MI 48093
Phone (586) 573-5890

Interoperability endpoints

  • Direct secure messaging: akennedy643085@direct.hfhs.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDIBBA

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1255976288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53423 JACLYN DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483151821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8244 METRO PKWY STE C",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483122778",
            "telephone_number": "586-795-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ARIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704266121",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704266121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.