Individual provider Active NPI

Ellen Marie Keefe-Garner, PMHNP-BC

  • Nurse Practitioner
  • Howell, MI
National Provider Identifier
1356922611
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704224601 Issued in MI
Practice address
2020 E Grand River Ave Ste 104
Howell, MI 48843-2478
Phone
(517) 545-5944
NPI assigned
Apr 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704224601 MI Primary

Addresses

Primary practice location

2020 E Grand River Ave Ste 104
Howell, MI 48843-2478

Mailing address

1610 Shadford Rd
Ann Arbor, MI 48104-4465
Phone (734) 604-8969

Other names 1

  • Miss Ellen Marie Keefe Former name

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
I20210519000670 MI Practitioner - Nurse Practitioner 6406255751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Livingston County Catholic CharitiesGroup PAC ID 8527972223, 9 clinicians

Practice addresses (Care Compare)

2895 W Grand River Ave
Howell, MI 48843-8538
Phone (517) 545-5944

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704224601MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Livingston County Catholic Charities CurrentSince May 1, 2021 Accepting new patients

Locations

2895 W Grand River Ave
Howell, MI 48843
Phone (517) 545-5944

2020 E Grand River Ave
Ste 104
Howell, MI 48843
Phone (517) 545-5944

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1356922611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 SHADFORD RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044465",
            "telephone_number": "734-604-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E GRAND RIVER AVE STE 104",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488432478",
            "telephone_number": "517-545-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE-GARNER",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704224601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "KEEFE",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Howell, MI

Sources for this page

Verify at the official NPI Registry.