NPIMap

Individual provider Active NPI

Carolann Kim Kinner, DO

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1306815089
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
CK012324 Issued in MI
Practice address
29703 Hoover Rd
Ste a
Warren, MI 48093-2544
Phone
(586) 558-4081
Fax
(586) 558-4082
NPI assigned
Mar 16, 2006
Last updated
Apr 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X CK012324 MI Primary

Addresses

Primary practice location

29703 Hoover Rd
Ste a
Warren, MI 48093-2544

Mailing address

29703 Hoover Rd
Ste a
Warren, MI 48093-8901
Phone (586) 558-4081

Other identifiers 8

IdentifierTypeStateIssuer
1185263OtherMIFIRST HEALTH
130255OtherMICARE CHOICES
5441662OtherMIAETNA
320018015 51OtherMIPPOM
0E01338OtherMIBCBSM
4494030 11MedicaidMI
G75704OtherMIHEALTH ALLIANCE PLAN
1316097942OtherMIUNITED HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101203001259 MI Practitioner - Internal Medicine 5496820979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
Henry Ford Physician PartnersGroup PAC ID 8921482605, 79 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

29703 Hoover Rd
Warren, MI 48093-8901
Phone (586) 558-4081

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
CK012324MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Mt. Clemens, PC Internal Medicine Current Accepting new patients
Diab & Kinner Internal Medicine, P.C. Internal Medicine CurrentSince Oct 14, 2002 Accepting new patients
Henry Ford Physician Partners CurrentSince Jun 1, 2024 Accepting new patients
Henry Ford Physician Partners Internal Medicine CurrentSince Jun 1, 2024 Accepting new patients
Henry Ford Macomb Ancillary Services Current Accepting new patients
Alliance Health Professionals, PLLC Internal Medicine Current Accepting new patients
Henry Ford Health Macomb Oakland Hospital Past Accepting new patients
Detroit Osteopathic Hospital Corporation Past Accepting new patients
Moyes Eye Center, P.C. Past Accepting new patients
Sloan Eyecare Center L.L.C Past Accepting new patients

Locations

133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880

29703 Hoover Rd
Warren, MI 48093
Phone (586) 573-9090

29703 Hoover Rd
Ste A
Warren, MI 48093
Phone (586) 558-4081

30050 Hoover Rd
Ste E
Warren, MI 48093
Phone (586) 558-4081

Interoperability endpoints

  • Direct secure messaging: ckinner57581@direct.hfhs.org

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1306815089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29703 HOOVER RD",
            "address_2": "STE A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480938901",
            "telephone_number": "586-558-4081",
            "fax_number": "586-558-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29703 HOOVER RD",
            "address_2": "STE A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932544",
            "telephone_number": "586-558-4081",
            "fax_number": "586-558-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNER",
        "first_name": "CAROLANN",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "CK012324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1185263",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "130255",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5441662",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "320018015 51",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0E01338",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4494030 11",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "G75704",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "1316097942",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.