Kairos Healthcare Incorporated

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

License

730157 Issued in MI

Legal business name

KAIROS HEALTHCARE INCORPORATED

Practice address

6379 Dixie Hwy
Bridgeport, MI 48722-9566

Phone

(989) 777-4357

Fax

(989) 777-7257

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Fred E. Wigen Jr.

Title

President/Ceo

Phone

(989) 777-4357

Specialties & licenses 4

Addresses

Other identifiers 5

Tax ID family

Kairos Healthcare Incorporated5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Kairos Healthcare Incorporated

  • Social Worker
  • Saginaw, MI
  • NPI 1174690648
  NPD tax ID
• Kairos Healthcare Incorporated

  • Social Worker
  • Bridgeport, MI
  • NPI 1184758435
  NPD tax ID
• Kairos Healthcare Incorporated

  • Substance Abuse Rehabilitation Facility
  • Saginaw, MI
  • NPI 1417023607
  NPD tax ID
• Kairos Healthcare Incorporated

  • Social Worker
  • Taylor, MI
  • NPI 1750457958
  NPD tax ID

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1427162239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6379 DIXIE HWY",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229566",
            "telephone_number": "989-777-4357",
            "fax_number": "989-777-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6379 DIXIE HWY",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229566",
            "telephone_number": "989-777-4357",
            "fax_number": "989-777-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIROS HEALTHCARE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "WIGEN",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "989-777-4357",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "730157",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "730157",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "730157",
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "MI",
            "license": "730157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PIN",
            "identifier": "328565",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "20520",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS PIN",
            "identifier": "0K47927",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCCLAREN PIN",
            "identifier": "1008848",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE PIN",
            "identifier": "14072",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamia Jones
• Morgan Hope Ju
• Nicole Marie Judson, PT, DPT
• Misty Rose Jura
• Kairos Healthcare Incorporated
• Nyah Lynn Rose Kelpinski
• Sreekant Kembhavi, BPHARM
• Kristina Marie Keys
• Kendrick Kilpatrick
• Brandon Knickerbocker

• Children's Substance Abuse Rehabilitation Facility in Bridgeport, MI
• Providers in Bridgeport, MI by specialty
• Children's Substance Abuse Rehabilitation Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.