Kenwood Allergy & Asthma Center, P.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

KENWOOD ALLERGY & ASTHMA CENTER, P.C.

Practice address

30170 23 Mile Rd
Chesterfield, MI 48047-2190

Phone

(586) 949-5900

Fax

(589) 949-5922

NPI assigned

Sep 2, 2005

Last updated

Jul 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pamela A Georgeson, DONPI 1619972486

Title

Owner

Phone

(586) 949-5900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela A Georgeson, DO

  • Allergy & Immunology Physician
  • Chesterfield, MI
  • NPI 1619972486
  Medicare reassignment Care Compare group NPD Authorized official
• Mark L Decco, MD

  • Allergy & Immunology Physician
  • Eastpointe, MI
  • NPI 1912083106
  Medicare reassignment Care Compare group NPD
• Vanessa Kondziolka, NP-C

  • Family Nurse Practitioner
  • Macomb, MI
  • NPI 1871735563
  Medicare reassignment Care Compare group NPD
• Michelle Malaj, NP

  • Family Nurse Practitioner
  • Chesterfield, MI
  • NPI 1316728165
  Medicare reassignment NPD
• Joan M Olear, NP

  • Nurse Practitioner
  • Eastpointe, MI
  • NPI 1912083114
  Medicare reassignment NPD
• Karla Ostaszewski, FNP

  • Family Nurse Practitioner
  • Macomb, MI
  • NPI 1972162337
  Medicare reassignment NPD

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184371200000",
    "number": "1508850777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30170 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480472190",
            "telephone_number": "586-949-5900",
            "fax_number": "589-949-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30170 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480472190",
            "telephone_number": "586-949-5900",
            "fax_number": "589-949-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENWOOD ALLERGY & ASTHMA CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2007-07-14",
        "status": "A",
        "authorized_official_last_name": "GEORGESON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-949-5900",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Kelly, PA
• Moniqua Kemp
• Kaitlyn Kenel
• Kayla Elizabeth Kent, PA-C, AT, ATC
• Madison Grace Kent
• Natalie Marie Kerry, RN
• Maerna Kersha, DMD
• Kendyl Ketelhut
• Kendra Keys
• Raven Keys

• Medical Specialty Clinic/Center in Chesterfield, MI
• Providers in Chesterfield, MI by specialty
• Medical Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.