Individual provider Active NPI

Kari Ann Mark, FNP

  • Family Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1508419177
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704276360 Issued in MI
Practice address
815 Business Park Dr Ste a
Traverse City, MI 49686-8683
Phone
(231) 421-6921
NPI assigned
Jul 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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 4704276360 MI Primary

Addresses

Primary practice location

815 Business Park Dr Ste a
Traverse City, MI 49686-8683

Mailing address

4020 Copper VW Ste 104
Traverse City, MI 49684-7041

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ccm@chronic-care.net Direct
Direct Messaging Address ccm@chronic-care.net Direct
Direct Messaging Address ccm@chronic-care.net Direct

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
I20190814003485 MI Practitioner - Nurse Practitioner 0749517670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chronic Care Management LLCGroup PAC ID 7214150770, 10 clinicians
Great Lakes Therapy Housecalls PCGroup PAC ID 7719876580, shared by 2 NPIs, 71 clinicians

Practice addresses (Care Compare)

815 Business Park Dr
Suite a
Traverse City, MI 49686-8683
Phone (231) 421-6921

9731 E Cherry Bend Rd
Traverse City, MI 49684-7621
Phone (231) 941-8100

Hospital & facility affiliations

  • Residential Home Health and Hospice Home health agency, Saginaw, MI, CCN 239152
  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chronic Care Management LLC Nurse Practitioner CurrentSince Jul 22, 2019 Accepting new patients

Locations

204 W Buttles St
Midland, MI 48640

801 Joe Mann Blvd
Ste P-6
Midland, MI 48642

810 Business Park Dr
Ste A
Traverse City, MI 49686
Phone (231) 421-6921

815 Business Park Dr
#A
Traverse City, MI 49686
Phone (231) 421-6921

4020 Copper Vw
Ste 104
Traverse City, MI 49684
Phone (231) 421-6921

4020 Copper Vw
Ste 101
Traverse City, MI 49684

Interoperability endpoints

  • Direct secure messaging: npalliative.karimark@149243.advancedmd-direct.com

Organizations & group practices 1

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 2

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": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1508419177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 COPPER VW STE 104",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 BUSINESS PARK DR STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496868683",
            "telephone_number": "231-421-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "KARI",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704276360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4020 Copper Vw Ste 104",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496847041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "810 Business Park Dr Ste A",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496868683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "815 Business Park Dr Ste A",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496868683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.