Individual provider Active NPI

Renita Jon Elder-Robinson, APRN, FNP-BC

  • Family Nurse Practitioner
  • Brownstown TWP, MI
National Provider Identifier
1508323882
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704235476 Issued in MI
Practice address
22990 King Rd
Brownstown TWP, MI 48183-1025
Phone
(248) 910-1814
NPI assigned
Feb 22, 2019
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704235476 MI Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704235476 MI

Addresses

Primary practice location

22990 King Rd
Brownstown TWP, MI 48183-1025

Mailing address

34564 Blackfoot St
Westland, MI 48185-2725
Phone (248) 910-1814

Other names 1

  • Renita Jon Elder-Robinson Professional name

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
I20190925001772 MI Practitioner - Nurse Practitioner 8224368865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hegira Health IncGroup PAC ID 3173429560, 41 clinicians

Practice addresses (Care Compare)

8623 N Wayne Rd
123 Childrens Outpatient Services
Westland, MI 48185-1137
Phone (734) 367-0469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hegira Health, Inc CurrentSince Nov 29, 2021 Accepting new patients
University Physician Group CurrentSince Jul 22, 2019 Accepting new patients
Hegira Health, Inc. CurrentSince Nov 29, 2021 Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4201 Saint Antoine St
Ste 5C
Detroit, MI 48201
Phone (313) 577-5030

1403 Inkster Rd
Inkster, MI 48141
Phone (313) 565-2200

26184 Outer Dr
Lincoln Park, MI 48146
Phone (313) 389-7500

37450 Schoolcraft Rd
Ste 110
Livonia, MI 48150
Phone (734) 458-4611

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

8623 N Wayne Rd
Ste 123
Westland, MI 48185
Phone (734) 367-0469

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1508323882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34564 BLACKFOOT ST",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481852725",
            "telephone_number": "248-910-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22990 KING RD",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831025",
            "telephone_number": "248-910-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER-ROBINSON",
        "first_name": "RENITA",
        "middle_name": "JON",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704235476",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704235476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENITA",
            "last_name": "ELDER-ROBINSON",
            "middle_name": "JON",
            "credential": "APRN, FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brownstown TWP, MI

Sources for this page

Verify at the official NPI Registry.