Andrea Kendall, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301504863 Issued in MI

Practice address

26850 Providence Pkwy Ste 455
Novi, MI 48374-1265

Phone

(248) 465-4847

Fax

(248) 465-4063

NPI assigned

Jun 27, 2018

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akendall513623@direct.hfhs.org

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.

• Henry Ford Health Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236
  Medicare reassignment NPD
• Henry Ford Health Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  Medicare reassignment
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1326533811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY STE 455",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741265",
            "telephone_number": "248-465-4847",
            "fax_number": "248-465-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY STE 455",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741265",
            "telephone_number": "248-465-4847",
            "fax_number": "248-465-4063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 East Medical Center Drive",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48109",
            "country_code": "US",
            "telephone_number": "734-647-1774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "ANDREA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301114966",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301504863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kinkead Kelly
• Mariah Kelly
• Rachel M Kelly
• Jvett Kemp
• Marcedas Latrice Kemp
• Katelyn Kendall
• Katherine Talin Kenderian
• Henriette Kengne
• Ana Kennedy
• Angelene Rose Kennedy, RN

• Pediatrics Physician in Novi, MI
• Providers in Novi, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.