Individual provider Active NPI

Amanpreet Kaur

  • Family Nurse Practitioner
  • Stevensville, MI
National Provider Identifier
1306679303
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4740370251 Issued in MI
Practice address
4368 Cleveland Ave
Stevensville, MI 49127-9595
Phone
(269) 983-6501
NPI assigned
Aug 23, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 4740370251 MI Primary

Addresses

Primary practice location

4368 Cleveland Ave
Stevensville, MI 49127-9595

Mailing address

2025 Joni LN
Stevensville, MI 49127-8459
Phone (269) 921-6399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250129000617 IN Practitioner - Nurse Practitioner 8325577802 Reassigns benefits to 1 organization
I20251114000743 MI Practitioner - Nurse Practitioner 8325577802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

4055 Valley View LN
Suite 700
Dallas, TX 75244-5045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4740370251MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Porte Clinic Company LLC CurrentSince Feb 23, 2025 Accepting new patients
La Porte Clinic Company LLC CurrentSince Feb 23, 2025 Accepting new patients

Locations

104 E Culver Rd
Ste 105
Knox, IN 46534
Phone (574) 772-7300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1306679303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 JONI LN",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491278459",
            "telephone_number": "269-921-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4368 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279595",
            "telephone_number": "269-983-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "AMANPREET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4740370251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MI

Sources for this page

Verify at the official NPI Registry.