Individual provider Active NPI

Kerri Ann Stephens, FNP

  • Family Nurse Practitioner
  • West Branch, MI
National Provider Identifier
1528329612
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704240636 Issued in MI
Practice address
2331 Progress St
Suite D
West Branch, MI 48661-9384
Phone
(989) 345-1184
Fax
(989) 345-6944
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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 4704240636 MI Primary

Addresses

Primary practice location

2331 Progress St
Suite D
West Branch, MI 48661-9384

Mailing address

2331 Progress St
Suite D
West Branch, MI 48661-9384
Phone (989) 345-1184

Other identifiers 1

IdentifierTypeStateIssuer
4704240636OtherMIRN & FNP LICENSE

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
I20121119000267 MI Practitioner - Nurse Practitioner 1658522792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

2110 S M
West Branch, MI 48661-8821

445 S Valley St
West Branch, MI 48661-9206
Phone (989) 345-3600

611 Court St
West Branch, MI 48661-8820
Phone (989) 345-7000

646 Court St
West Branch, MI 48661-8781
Phone (989) 343-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704240636MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan Current Accepting new patients
McLaren Central Michigan CurrentSince Jul 21, 2020 Accepting new patients
McLaren Central Michigan CurrentSince Jul 21, 2020 Accepting new patients
McLaren Primary Care Past Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

2110 S M 76
Ste 6
West Branch, MI 48661
Phone (989) 345-1184

Organizations & group practices 5

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 4

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1528329612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 PROGRESS ST",
            "address_2": "SUITE D",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619384",
            "telephone_number": "989-345-1184",
            "fax_number": "989-345-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 PROGRESS ST",
            "address_2": "SUITE D",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619384",
            "telephone_number": "989-345-1184",
            "fax_number": "989-345-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KERRI",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704240636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN & FNP LICENSE",
            "identifier": "4704240636",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Branch, MI

Sources for this page

Verify at the official NPI Registry.