Individual provider Active NPI

Amber L. Kokkonen, N.P.

  • Family Nurse Practitioner
  • Laurium, MI
National Provider Identifier
1558770495
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704253702 Issued in MI
Practice address
300 Hecla St
Laurium, MI 49913-2128
Phone
(906) 337-9355
Fax
(906) 337-4788
NPI assigned
Aug 5, 2014
Last updated
Nov 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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 4704253702 MI Primary

Addresses

Primary practice location

300 Hecla St
Laurium, MI 49913-2128

Mailing address

300 Hecla St
Laurium, MI 49913-2128
Phone (906) 337-9355

Other identifiers 1

IdentifierTypeStateIssuer
1558770495MedicaidMI

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
I20150708003075 MI Practitioner - Nurse Practitioner 6709108947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus KeweenawGroup PAC ID 8123912011, shared by 7 NPIs, 116 clinicians

Practice addresses (Care Compare)

1000 Cedar St
Houghton, MI 49931-1978
Phone (906) 487-1710

110 Calumet St
Lake Linden, MI 49945-1308
Phone (906) 296-5040

205 Osceola St
Laurium, MI 49913-2134
Phone (906) 337-3100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Keweenaw CurrentSince Jun 18, 2015 Accepting new patients
Aspirus Keweenaw Current Accepting new patients
Aspirus Keweenaw CurrentSince Jun 18, 2015 Accepting new patients
Aspirus Keweenaw Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1000 Cedar St
Houghton, MI 49931
Phone (906) 482-8201

1000 Cedar St
Ste 3
Houghton, MI 49931

110 Calumet St
Lake Linden, MI 49945
Phone (906) 296-5040

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

205 Osceola St
Fl 1
Laurium, MI 49913

300 Hecla St
Laurium, MI 49913
Phone (906) 337-9355

Interoperability endpoints

  • Direct secure messaging: akokkonen105597@direct.aspirus.org

Organizations & group practices 4

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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1558770495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HECLA ST",
            "city": "LAURIUM",
            "state": "MI",
            "postal_code": "499132128",
            "telephone_number": "906-337-9355",
            "fax_number": "906-337-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HECLA ST",
            "city": "LAURIUM",
            "state": "MI",
            "postal_code": "499132128",
            "telephone_number": "906-337-9355",
            "fax_number": "906-337-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKKONEN",
        "first_name": "AMBER",
        "middle_name": "L.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704253702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558770495",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurium, MI

Sources for this page

Verify at the official NPI Registry.