NPIMap

Individual provider Active NPI

Lori Jean Kueffner, PA

  • Physician Assistant
  • Caro, MI
National Provider Identifier
1558478024
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601001640 Issued in MI
Practice address
1525 W Caro Rd
Caro, MI 48723-9260
Phone
(989) 672-2100
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601001640 MI Primary

Addresses

Primary practice location

1525 W Caro Rd
Caro, MI 48723-9260

Mailing address

1003 Woodside Ave
Essexville, MI 48732-1234
Phone (989) 892-7722

Other identifiers 3

IdentifierTypeStateIssuer
1689022469MedicaidMI
1659326395MedicaidMI
4800281MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000017 MI Practitioner - Physician Assistant 9830158468 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shattuck Family Physicians PLLCGroup PAC ID 4486949807, 16 clinicians
Caro Express Clinic PLCGroup PAC ID 5294760922, 7 clinicians

Practice addresses (Care Compare)

1525 W Caro Rd
Caro, MI 48723-9686

2425 Austins Pkwy
Suite 1
Flint, MI 48507-1344
Phone (810) 238-8889

Hospital & facility affiliations

  • Harmony at Home Hospice, LLC Hospice, Chesaning, MI, CCN 231721
  • Harmony Home Health and Hospice Care Hospice, Saginaw, MI, CCN 231675
  • McLaren Caro Region Hospital, Caro, MI, CCN 231329
  • Hills & Dales General Hospital Hospital, Cass City, MI, CCN 231316
  • Covenant Medical Center Hospital, Saginaw, MI, CCN 230070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Caro Health Plaza PLC CurrentSince Dec 1, 2005 Accepting new patients
McLaren Caro Region Past Accepting new patients

Locations

1525 W Caro Rd
Ste A
Caro, MI 48723
Phone (989) 860-0088

1525 W Caro Rd
Caro, MI 48723
Phone (989) 672-2100

Interoperability endpoints

  • Direct secure messaging: lori.kueffner.1@20296.direct.athenahealth.com

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 6

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1558478024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 WOODSIDE AVE",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487321234",
            "telephone_number": "989-892-7722",
            "fax_number": "989-892-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239260",
            "telephone_number": "989-672-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEFFNER",
        "first_name": "LORI",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689022469",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659326395",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4800281",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caro, MI

Sources for this page

Verify at the official NPI Registry.