Kimberly Lussier

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704345902 Issued in MI

Practice address

1535 Gull Rd
Kalamazoo, MI 49048-1650

Phone

(419) 262-1324

NPI assigned

Feb 25, 2020

Last updated

Jan 4, 2022By 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 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Beacon Medical Group Michigan Inc

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869
  Medicare reassignment NPD
• Promed Healthcare

  dba Borgess Women's Health

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1306470729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 HEMLOCK RD",
            "city": "QUINCY",
            "state": "MI",
            "postal_code": "490829630",
            "telephone_number": "419-262-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481650",
            "telephone_number": "419-262-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSSIER",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "33546",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704345902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Jane Lung, PTA
• Min Luo, D.O.
• Lynn Nylund Lupini, PH.D.
• Scott T. Luppe, ED.D.
• Eriks Antons Lusis, M.D.
• Jacob Lutz
• Lucille Frances Lutz, NURSE PRACTITIONER
• Patricia Lutz, CRNA
• Luxottica of America Inc (Target Optical # Q727)
• Luxottica Retail North America Inc (Pearle Vision #C6869)

• Family Nurse Practitioner in Kalamazoo, MI
• Providers in Kalamazoo, 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 Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.