Individual provider Active NPI

Kylie J Kattelus, FNP

  • Family Nurse Practitioner
  • Owosso, MI
National Provider Identifier
1467044941
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704275840 Issued in MI
Practice address
819 N Shiawassee St Ste 110
Owosso, MI 48867-1601
Phone
(989) 723-1390
Fax
(989) 725-1415
NPI assigned
Feb 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704275840 MI Primary

Addresses

Primary practice location

819 N Shiawassee St Ste 110
Owosso, MI 48867-1601

Mailing address

819 N Shiawassee St Ste 110
Owosso, MI 48867-1601
Phone (989) 723-1390

Other practice location 1

2525 Jolly Rd Ste 240
Okemos, MI 48864-3681
Phone (989) 729-4304

Other identifiers 1

IdentifierTypeStateIssuer
1467044941MedicaidMI

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211206000748 MI Practitioner - Nurse Practitioner 8628468766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

2525 Jolly Rd
Suite 240
Okemos, MI 48864-3681
Phone (989) 729-4304

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
58.15
Promoting interoperability
100
Improvement activities
40
Cost
74.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
4704275840MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Nurse Practitioner Current Accepting new patients
Memorial Hospital Family CurrentSince Jan 1, 2022 Accepting new patients
Memorial Hospital CurrentSince Jan 1, 2022 Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

2525 Jolly Rd
Ste 240
Okemos, MI 48864
Phone (855) 276-2111

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

818 W King St
Ste 101
Owosso, MI 48867
Phone (989) 723-1390

1975 W M 21
Ste 103
Owosso, MI 48867

819 N Shiawassee St
Ste 110
Owosso, MI 48867
Phone (989) 723-1390

Interoperability endpoints

  • Direct secure messaging: k.kattelus@memorialhealthcare.midirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1612569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1467044941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N SHIAWASSEE ST STE 110",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671601",
            "telephone_number": "989-723-1390",
            "fax_number": "989-725-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N SHIAWASSEE ST STE 110",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671601",
            "telephone_number": "989-723-1390",
            "fax_number": "989-725-1415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Jolly Rd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488643681",
            "country_code": "US",
            "telephone_number": "989-729-4304",
            "fax_number": "989-729-4308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATTELUS",
        "first_name": "KYLIE",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-06",
        "last_updated": "2022-06-08",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704275840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467044941",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.