Kelley Kummer, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

4704406880 Issued in MI

Practice address

22170 W 9 Mile Rd
Southfield, MI 48033-6007

Phone

(248) 372-6980

Fax

(248) 355-1402

NPI assigned

Aug 15, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1508649559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 W MADGE AVE",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480302043",
            "telephone_number": "313-506-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22170 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480336007",
            "telephone_number": "248-372-6980",
            "fax_number": "248-355-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMMER",
        "first_name": "KELLEY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704406880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mara Kulesa
• John Kulish, M.D.
• Shraddha Kulkarni, MSPT
• Tanmay Ajay Kulkarni, PT
• Kalpana Kumar
• Jason Bernard James Kurek, DPM
• Yasmine Kurishi
• Lawrence T Kurz, MD
• Ian Kuschell
• Ruby E Kushner, MSW

• Psychiatric/Mental Health Registered Nurse in Southfield, MI
• Providers in Southfield, MI by specialty
• Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.