Active NPI
Kayla Elizabeth Simon, MD
- Student in an Organized Health Care Education/Training Program
- Detroit, MI
National Provider Identifier
1396494944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 22151 Moross Rd Ste 214
Detroit, MI 48236-2151 - Phone
- (313) 343-4867
- Fax
- (313) 343-3280
- NPI assigned
- Mar 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
22151 Moross Rd Ste 214
Detroit, MI 48236-2151
Mailing address
22151 Moross Rd Ste 214
Detroit, MI 48236-2151
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220520000413 | MI | Order and Referring Only - General Surgery | 3476930058 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1396494944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22151 MOROSS RD STE 214",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22151 MOROSS RD STE 214",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362151",
"telephone_number": "313-343-4867",
"fax_number": "313-343-3280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "KAYLA",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-21",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
- Sandra Denise Simmons, LLPC
- Thamyryz Rafaela Almeida Simoes, DDS
- Michael J. Simoff, M.D.
- Marci Lavaughn Simon-Burrell, MSN, RN, WHNP-BC
- Ibtisam Hassan Simon, DNP, FNP-BC
- Michael Steven Simon, MD MPH
- Rebecca Marie Simon, D.O.
- Tarcia Letrece Simon, RN
- Christopher Michael Simone, P.T.
- Rozeline Simonis, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.