Katelyn Peticca O'Brien, RN, MSN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704300190 Issued in MI

Practice address

3525 Karen Pkwy Apt 204
Waterford, MI 48328-4609

Phone

(248) 568-0692

NPI assigned

May 13, 2019

Last updated

Jul 30, 2024By 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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

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.

• Elizabeth Lake Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Waterford, MI
  • NPI 1538585260
  Medicare reassignment NPD
• Lakeside Urgent Care, P. C.

  • Urgent Care Clinic/Center
  • Clinton Township, MI
  • NPI 1720159304
  Medicare reassignment NPD
• Oxford Urgent Care P L C

  • Specialist
  • Oxford, MI
  • NPI 1700036936
  Medicare reassignment NPD
• Royal Urgent Care, PLLC

  • Internal Medicine Physician
  • Royal Oak, MI
  • NPI 1952833196
  Medicare reassignment NPD
• Metro Infectious Disease Consultants, LLC

  dba Midc, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717

  MI, Nurse Practitioner

  Medicare reassignment NPD
• Lakeside Urgent Care, P.C.

  • Internal Medicine Physician
  • Clinton Township, MI
  • NPI 1811226442
  NPD
• Somerset Urgent Care PLLC

  • Family Medicine Physician
  • Troy, MI
  • NPI 1124461702
  NPD
• Somerset Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Troy, MI
  • NPI 1679916258
  NPD
• Washington Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Washington Township, MI
  • NPI 1891045563
  NPD
• Metro Infectious Disease Consultants LLC

  dba Midc

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD
• First Choice Urgent Care PC

  • Urgent Care Clinic/Center
  • Dearborn, MI
  • NPI 1629201264
  NPD (past)
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Plymouth, MI
  • NPI 1841530250
  NPD (past)

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1396301685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 KAREN PKWY APT 204",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483284609",
            "telephone_number": "248-568-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 KAREN PKWY APT 204",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483284609",
            "telephone_number": "248-568-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KATELYN",
        "middle_name": "PETICCA",
        "credential": "RN, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704300190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Novacare Outpatient Rehabilitation East Inc (NovaCare Rehabilitation)
• Ariel Lorraine Novak, LLMSW
• Ashley Novicoff
• Jaime L Nowak, M.P.T.
• Nrmi, LLC
• Seth O'Connor, LMSW
• Joanna O'Dacre
• Amy Elizabeth O'Neil, DO
• Caitlin O'Neill, LLPC
• Oakland County Urologists PC

• Family Nurse Practitioner in Waterford, MI
• Providers in Waterford, 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 Jul 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.