Individual provider Active NPI

Kacie Hadley, CNP

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1265944102
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704330248 Issued in MI
Practice address
4200 Whitehall Dr Ste 130
Ann Arbor, MI 48105-9694
Phone
(734) 995-0303
Fax
(734) 995-0425
NPI assigned
Nov 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704330248 MI Primary

Addresses

Primary practice location

4200 Whitehall Dr Ste 130
Ann Arbor, MI 48105-9694

Mailing address

24 Frank Lloyd Wright Dr Lbby J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other practice location 1

2386 Jonathan Ct
Ann Arbor, MI 48108
Phone (801) 592-3862

Other practice location 2

2386 Jonathan Ct
Ann Arbor, MI 48108
Phone (801) 592-3862

Other practice location 3

1325 N West Ave
Jackson, MI 49202-2050
Phone (517) 768-0384

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
I20171121001040 MI Practitioner - Nurse Practitioner 2567729940 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704330248MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation Nurse Practitioner CurrentSince Jan 1, 2019 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Jan 1, 2019 Accepting new patients

Locations

4200 Whitehall Dr
Ste 130
Ann Arbor, MI 48105
Phone (734) 995-0303

3200 W Liberty Rd
Ste C
Ann Arbor, MI 48103
Phone (734) 761-2581

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

4990 W Clark Rd
Ste 200
Ypsilanti, MI 48197
Phone (734) 572-7500

4940 W Clark Rd
Ste 100
Ypsilanti, MI 48197
Phone (734) 434-0477

Interoperability endpoints

  • Direct secure messaging: khadley36361@direct.trinity-health.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1265944102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR LBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WHITEHALL DR STE 130",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059694",
            "telephone_number": "734-995-0303",
            "fax_number": "734-995-0425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2386 Jonathan Ct",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48108",
            "country_code": "US",
            "telephone_number": "801-592-3862",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2386 Jonathan Ct",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48108",
            "country_code": "US",
            "telephone_number": "801-592-3862",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 N West Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492022050",
            "country_code": "US",
            "telephone_number": "517-768-0384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "KACIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704330248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.