Individual provider Active NPI

Kelly Kretschmann, APRN, NP

  • Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1346003217
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704314258 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(248) 953-4573
NPI assigned
Feb 2, 2024
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704314258 MI Primary
Critical Care Medicine Registered Nurse 163WC0200X 4704314258 MI

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

2507 Woodland Ave
Royal Oak, MI 48073-3035
Phone (248) 953-4573

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250403003282 MI Practitioner - Nurse Practitioner 5698299352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Nsa Pain Services of Michigan III, PLLCGroup PAC ID 8921428996, 18 clinicians
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

10000 Telegraph Rd
Taylor, MI 48180-3330
Phone (214) 687-0001

33155 Annapolis St
Wayne, MI 48184-2405
Phone (214) 687-0001

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (214) 687-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nsa Pain Services of Michigan III, PLLC CurrentSince Jan 25, 2025 Accepting new patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Jan 25, 2025 Accepting new patients
Michigan Wellness Associates PC Past Accepting new patients

Locations

16815 E Jefferson Ave
Grosse Pointe, MI 48230
Phone (313) 473-4690

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

3601 W 13 Mile Rd
Royal Oak, MI 48073

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

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.

Hospital & facility affiliations 4

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": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1346003217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 WOODLAND AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480733035",
            "telephone_number": "248-953-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-953-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRETSCHMANN",
        "first_name": "KELLY",
        "credential": "APRN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704314258",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MI",
            "license": "4704314258",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.