Individual provider Active NPI

Amy J Kirkpatrick, FNP-C

  • Family Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1568248102
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704242946 Issued in MI
Practice address
968 S Ridge CT
Traverse City, MI 49696-8627
Phone
(231) 883-2435
NPI assigned
Sep 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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 4704249646 MI
Family Nurse Practitioner 363LF0000X 4704242946 MI Primary
Case Management Agency 251B00000X

Addresses

Primary practice location

968 S Ridge CT
Traverse City, MI 49696-8627

Mailing address

968 S Ridge CT
Traverse City, MI 49696-8627
Phone (231) 883-2435

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
I20231117000584 MI Practitioner - Nurse Practitioner 5294182952 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

220 S Hughston St
MC Bain, MI 49657-9622
Phone (231) 825-2990

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704249646MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest H PLLC CurrentSince Aug 14, 2025 Accepting new patients
Theoria Medical CurrentSince Sep 29, 2024 Accepting new patients
Michigan Sports and Spine Center PC CurrentSince Oct 4, 2023 Accepting new patients

Locations

335 Illinois St
Crystal Lake, IL 60014
Phone (815) 459-7791

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

540 Sunnyside Dr
Flushing, MI 48433
Phone (810) 487-0045

11941 Belsay Rd
Grand Blanc, MI 48439
Phone (810) 694-1970

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

18312 Middlebelt Rd
Livonia, MI 48152
Phone (248) 426-9944

220 S Hughston St
Mc Bain, MI 49657
Phone (231) 825-2990

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

1819 E Big Beaver Rd
Ste 210
Troy, MI 48083
Phone (248) 680-9000

6950 Farmington Rd
West Bloomfield, MI 48322
Phone (248) 478-5645

28 S Prospect St
Ypsilanti, MI 48198
Phone (734) 483-2220

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1568248102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 S RIDGE CT",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496968627",
            "telephone_number": "231-883-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 S RIDGE CT",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496968627",
            "telephone_number": "231-883-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "AMY",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704249646",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704242946",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.