Individual provider Active NPI

Kamelia Burrell-Fowler, FNP

  • Nurse Practitioner
  • Saint Joseph, MI
National Provider Identifier
1528633898
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704397655 Issued in MI
Practice address
3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158
Phone
(269) 983-0500
Fax
(269) 429-2240
NPI assigned
May 20, 2021
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704397655 MI
Family Nurse Practitioner 363LF0000X 0024181262 VA
Nurse Practitioner 363L00000X 4704397655 MI Primary

Addresses

Primary practice location

3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158

Mailing address

3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158
Phone (269) 983-0500

Other practice location 1

1452 Chain Bridge Rd
Mc Lean, VA 22101-3706
Phone (703) 307-8235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230215000569 DC Practitioner - Nurse Practitioner 0547650301 Reassigns benefits to 1 organization
I20230417000801 MI Practitioner - Nurse Practitioner 0547650301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

3950 Hollywood Rd
Suite 270
Saint Joseph, MI 49085-9158
Phone (269) 983-0500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704397655MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Apr 6, 2023 Accepting new patients
Lakeland Medical Practices CurrentSince Apr 6, 2023 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jan 26, 2023 Accepting new patients

Locations

1015 15th St NW
Ste 1000
Washington, DC 20005
Phone (833) 815-2200

3950 Hollywood Rd
Ste 270
Saint Joseph, MI 49085
Phone (269) 982-7840

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 355-4719

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: kburrellfowler1462624@epic00.corewelldirect.org

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.

Hospital & facility affiliations 3

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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1528633898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 270",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859158",
            "telephone_number": "269-983-0500",
            "fax_number": "269-429-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 270",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859158",
            "telephone_number": "269-983-0500",
            "fax_number": "269-429-2240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1452 Chain Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221013706",
            "country_code": "US",
            "telephone_number": "703-307-8235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURRELL-FOWLER",
        "first_name": "KAMELIA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704397655",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024181262",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704397655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.