Kelly Lynn Dobrzeniecki, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704271783 Issued in MI

Practice address

15125 22 Mile Rd
Shelby Township, MI 48315-4406

Phone

(586) 532-0599

Fax

(586) 566-8967

NPI assigned

Nov 7, 2014

Last updated

Nov 7, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shelby Pediatric Associates and Child Lung Center PC

  • Pediatrics Physician
  • Shelby Township, MI
  • NPI 1124051990
  NPD (past)

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1275939928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15125 22 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154406",
            "telephone_number": "586-532-0599",
            "fax_number": "586-566-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15125 22 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154406",
            "telephone_number": "586-532-0599",
            "fax_number": "586-566-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRZENIECKI",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704271783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alessandra Vita Maria Dipace
• Susan Dipple
• Arnaldo I Direzze, D.D.S.
• Robert Dix
• John G Dixon, D.D.S.
• Dolan Optometry P C
• David Brandon Dolan, O.D
• Laurie A Donahue, MS ATC
• Donna M Ulrich Termini PLLC
• Donna Ulrich-Termini, PLLC

• Family Nurse Practitioner in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.