Individual provider Active NPI

Emily Kenyon, DO

  • Student in an Organized Health Care Education/Training Program
  • Mount Clemens, MI
National Provider Identifier
1477245090
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1000 Harrington St
Mount Clemens, MI 48043-2920
Phone
(586) 493-3740
NPI assigned
May 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1000 Harrington St
Mount Clemens, MI 48043-2920

Mailing address

1000 Harrington St
Mount Clemens, MI 48043-2920

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030003091 MI Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 2769838598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5151015994MIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1477245090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENYON",
        "first_name": "EMILY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "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 Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.