Individual provider Active NPI

Holly Anita Kerr, M.D.

  • Dermatology Physician
  • Detroit, MI
National Provider Identifier
1376751784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
L1020114 Issued in MI
Practice address
3031 W Grand Blvd
Suite 800, Dept of Dermatology
Detroit, MI 48202-3046
Phone
(313) 916-2160
NPI assigned
May 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X L1020114 MI Primary

Addresses

Primary practice location

3031 W Grand Blvd
Suite 800, Dept of Dermatology
Detroit, MI 48202-3046

Mailing address

1450 Lisgar
Lasalle, ONTARIO N9J 3N1
CA
Phone (519) 250-6473

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000064 MI Practitioner - Dermatology 5294828182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608

2799 W Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 876-2151

2825 Livernois Rd
Troy, MI 48083-1214
Phone (248) 528-2310

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions267
Removal or shaving of skin growth1-10
Skin biopsy94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L1020114MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Dermatology CurrentSince Aug 1, 2007 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Aug 1, 2007 Accepting new patients

Locations

1 Ford Pl
#2E
Detroit, MI 48202
Phone (313) 874-4688

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3031 W Grand Blvd
Detroit, MI 48202
Phone (313) 871-3751

3031 W Grand Blvd
Ste 800
Detroit, MI 48202
Phone (313) 916-2151

2825 Livernois Rd
Troy, MI 48083
Phone (248) 680-2060

Interoperability endpoints

  • Direct secure messaging: hkerr16912@direct.hfhs.org
  • Direct secure messaging: holly.kerr.1@18430.direct.athenahealth.com

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 2

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376751784",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "1450 LISGAR",
            "city": "LASALLE",
            "state": "ONTARIO",
            "postal_code": "N9J 3N1",
            "telephone_number": "519-250-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD",
            "address_2": "SUITE 800, DEPT OF DERMATOLOGY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023046",
            "telephone_number": "313-916-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "HOLLY",
        "middle_name": "ANITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "L1020114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.