Carly Knudsen, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704317815 Issued in MI

Practice address

50505 Schoenherr Rd
Ste 340
Shelby Township, MI 48315-3140

Phone

(586) 731-8400

Fax

(586) 731-8406

NPI assigned

Sep 17, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Primary Medicine PC

  • Internal Medicine Physician
  • Bloomfield Hills, MI
  • NPI 1427625292
  Medicare reassignment NPD
• Baldwin Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Bloomfield Hills, MI
  • NPI 1275285645
  NPD
• Alpha Urgent Care PLLC

  • Health Service Clinic/Center
  • Rochester Hills, MI
  • NPI 1326630716
  NPD (past)
• Vax Solution Inc

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1083210488
  NPD (past)

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1366092769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "STE 340",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-731-8400",
            "fax_number": "586-731-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD",
            "address_2": "STE 340",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153140",
            "telephone_number": "586-731-8400",
            "fax_number": "586-731-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSEN",
        "first_name": "CARLY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704317815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Klakulak
• Leah Klauss, RN
• Suzanne Klein-Overmeer
• Sophia Rose Klein
• Kaitlyn Knaack
• Gregory B Koby, D.O.
• Elizabeth Koch, FNP
• Katherine Koch, PT, DPT, OMPT
• Dana Marie Kopacz
• Haley Korbel, FNP

• Family Nurse Practitioner in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.