Individual provider Active NPI

Kelli Fritz, DO

  • Emergency Medicine Physician
  • Southfield, MI
National Provider Identifier
1477592699
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101014296 Issued in MI
Practice address
18161 W 13 Mile Rd
Suite a-2
Southfield, MI 48076-1113
Phone
(248) 642-9893
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101014296 MI Primary

Addresses

Primary practice location

18161 W 13 Mile Rd
Suite a-2
Southfield, MI 48076-1113

Mailing address

18161 W 13 Mile Rd
Suite a-2
Southfield, MI 48076-1113
Phone (248) 642-9893

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
I20040713000646 MI Practitioner - Emergency Medicine 5799763934 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Nova Southeastern College of Osteo Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Practice addresses (Care Compare)

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

Hospital & facility affiliations

  • McLaren Flint Hospital, Flint, MI, CCN 230141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101014296MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Department Physicians, P.C. Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
McLaren Hospital Group Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Degara App, PLLC Emergency Medicine CurrentSince Oct 1, 2018 Accepting new patients

Locations

4100 S River Rd
East China, MI 48054
Phone (810) 329-6677

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

17717 Masonic
Fraser, MI 48026
Phone (586) 294-0600

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

1375 N Main St
Lapeer, MI 48446
Phone (810) 667-5500

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 3

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 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477592699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18161 W 13 MILE RD",
            "address_2": "SUITE A-2",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761113",
            "telephone_number": "248-642-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18161 W 13 MILE RD",
            "address_2": "SUITE A-2",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761113",
            "telephone_number": "248-642-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITZ",
        "first_name": "KELLI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101014296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.