Kristin Michelle Kennaugh, RN, BSN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704230867NSA190N6 Issued in MI

Practice address

1557 Crimson Dr
Troy, MI 48083-5506

Phone

(248) 379-1863

NPI assigned

Apr 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

FD Farah Mi PLLCGroup PAC ID 3971739368, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkennaugh554103@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• FD Farah Mi PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Rochester Hills, MI
  • NPI 1730528258
  Medicare reassignment Care Compare group NPD
• Michigan Infectious Disease Associates, PC

  • Infectious Disease Physician
  • Warren, MI
  • NPI 1336346030
  Medicare reassignment NPD

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1427611052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 CRIMSON DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 CRIMSON DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835506",
            "telephone_number": "248-379-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNAUGH",
        "first_name": "KRISTIN",
        "middle_name": "MICHELLE",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MI",
            "license": "4704230867",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704230867NSA190N6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Michael Kelly, DPT
• Aalicia Kemp
• Charlene Kemp
• Zeinab Kenaan, PA
• Amanda Kendrick, NP
• Jessica Frances Kennedy, FNP
• Kaitlyn Elisabeth Kennedy, PT, DPT
• Kenneth W. Shaheen, M.D.,P.C.
• David M Kent, D.O.
• Gina Katherine Kent, MA LPC

• Nurse Practitioner in Troy, MI
• Providers in Troy, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.