Individual provider Active NPI

Gaia Kile, MSN RN-CS

  • Family Nurse Practitioner
  • Plymouth, MI
National Provider Identifier
1265478176
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704195120 Issued in MI
Practice address
340 N Main St Ste 200
Plymouth, MI 48170-1250
Phone
(734) 335-0028
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 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 4704195120 MI Primary

Addresses

Primary practice location

340 N Main St Ste 200
Plymouth, MI 48170-1250

Mailing address

522 Miller Ave
Ann Arbor, MI 48103-3342
Phone (734) 994-4937

Other practice location 1

210 Little Lake Dr
suite 10
Ann Arbor, MI 48103-6218
Phone (734) 332-9936

Other identifiers 1

IdentifierTypeStateIssuer
4561594MedicaidMI

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
I20080112000159 MI Practitioner - Nurse Practitioner 3678654993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simply Mindful Counseling LLCGroup PAC ID 6800282963, 12 clinicians

Practice addresses (Care Compare)

340 N Main St
Suite 201
Plymouth, MI 48170-1290
Phone (734) 335-0605

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704195120MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Simply Mindful Counseling, LLC CurrentSince Jun 17, 2023 Accepting new patients

Locations

340 N Main St
Ste 200
Plymouth, MI 48170
Phone (734) 335-0028

340 N Main St
Ste 201
Plymouth, MI 48170
Phone (734) 335-0605

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1265478176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 MILLER AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481033342",
            "telephone_number": "734-994-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N MAIN ST STE 200",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701250",
            "telephone_number": "734-335-0028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Little Lake Dr",
            "address_2": "suite 10",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481036218",
            "country_code": "US",
            "telephone_number": "734-332-9936",
            "fax_number": "206-666-2989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILE",
        "first_name": "GAIA",
        "name_prefix": "Mr.",
        "credential": "MSN RN-CS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704195120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4561594",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.