Kevin Poole Jr., REGISTERED NURSE

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

4704350959 Issued in MI

Practice address

3044 Shabay Dr BLDG 1
Flushing, MI 48433-2459

Phone

(810) 265-8514

NPI assigned

Jul 1, 2020

Last updated

Jul 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kevin.poole@mclaren.org

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1598382905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 SHABAY DR BLDG 1",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484332459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 SHABAY DR BLDG 1",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484332459",
            "telephone_number": "810-265-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "KEVIN",
        "name_suffix": "Jr.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MI",
            "license": "4704350959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "4704350959",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kevin.poole@mclaren.org",
            "affiliation": "N",
            "address_1": "3044 Shabay Dr Bldg 1",
            "city": "Flushing",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484332459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Terresa Plowman, D.C
• Molly Pocsi
• Martha Polakowski
• Elaine Pomerantz
• Aereonna Victoria Pool, LLMSW
• Lashonda Pope
• Natasha Potvin
• Laishai Powell
• Lenice Powell
• Josiah Murray Pratt

• Medical-Surgical Registered Nurse in Flushing, MI
• Providers in Flushing, MI by specialty
• Medical-Surgical Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.