Individual provider Active NPI

Allie Kendall

  • Family Nurse Practitioner
  • Holland, MI
National Provider Identifier
1265131452
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704348651 Issued in MI
Practice address
167 E 39TH St
Holland, MI 49423-7015
Phone
(989) 860-3426
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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 4704348651 MI Primary

Addresses

Primary practice location

167 E 39TH St
Holland, MI 49423-7015

Mailing address

167 E 39TH St
Holland, MI 49423-7015

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
I20230515002469 MI Practitioner - Nurse Practitioner 2062878127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Rapids Womens Health PCGroup PAC ID 8729162185, 21 clinicians

Practice addresses (Care Compare)

555 Midtown St NE
Suite 400
Grand Rapids, MI 49503-5731
Phone (616) 588-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704348651MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Rapids Womens Health PC CurrentSince Oct 1, 2023 Accepting new patients

Locations

555 Midtowne St NE
Ste 400
Grand Rapids, MI 49503
Phone (616) 588-1200

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.

Hospital & facility affiliations 2

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1265131452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 E 39TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 E 39TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237015",
            "telephone_number": "989-860-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "ALLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704348651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.