Active NPI
Kimberly Meisenhelder, M.D.
- Pediatrics Physician
- Plymouth, MI
National Provider Identifier
1336257740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301405923
- Practice address
- 990 W Ann Arbor TRL
Suite 210
Plymouth, MI 48170-6204 - Phone
- (734) 455-4600
- Fax
- (734) 455-5637
- NPI assigned
- Aug 26, 2006
- Last updated
- Nov 25, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301405923 | MI | Primary |
Addresses
Primary practice location
990 W Ann Arbor TRL
Suite 210
Plymouth, MI 48170-6204
Mailing address
24 Frank Lloyd Wright Dr
P.O. Box 0446, Lobby J
Ann Arbor, MI 48105-9484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301405923 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iha Health Service Corporation | Pediatrics | Past | Accepting new patients |
| Iha Health Services Corporation | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba IHA Livonia Pediatrics
- Pediatrics Physician
- Livonia, MI
- NPI 1033794771
-
dba Trinity Health IHA Medical Group Pediatrics
- Pediatrics Physician
- Ann Arbor, MI
- NPI 1417004003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259107200000",
"number": "1336257740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 FRANK LLOYD WRIGHT DR",
"address_2": "P.O. BOX 0446, LOBBY J",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 W ANN ARBOR TRL",
"address_2": "SUITE 210",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481706204",
"telephone_number": "734-455-4600",
"fax_number": "734-455-5637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEISENHELDER",
"first_name": "KIMBERLY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-26",
"last_updated": "2009-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301405923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.