Kathleen L. McKenna, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704275083 Issued in MI

Practice address

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

Phone

(248) 898-4021

Fax

(248) 898-1473

NPI assigned

Nov 1, 2016

Last updated

Nov 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

John Kitzmiller M.D. PCGroup PAC ID 7911131297, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John Kitzmiller M.D. PC

  dba Bald Mountain Behavioral Medicine

  • Addiction Medicine (Family Medicine) Physician
  • Lake Orion, MI
  • NPI 1518393800
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1366994816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR",
            "address_2": "203",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-585-8250",
            "fax_number": "248-585-8270"
        },
        {
            "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": "248-898-4021",
            "fax_number": "248-898-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "KATHLEEN",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704275083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia McGraw, ATR-BC
• Mekeia McGuire-Reese
• Nora A McHeik, DO, MS
• Brian Edward McIntosh
• Michael James McIntosh, M.D.
• Colleen McKevitt, CRNA
• Susan Helen McKinnon, NP
• Victoria Elizabeth McKinnon, MD, FRCSC
• Kathleen A McLaughlin, CNM
• Lindsey Faye McLaughlin, D.O.

• Nurse Practitioner in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.