Active NPI
Kelly Katona
- Pediatrics Physician
- Ann Arbor, MI
National Provider Identifier
1609440916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301511474
- Practice address
- 3055 Plymouth Rd Ste 202
Ann Arbor, MI 48105-3208 - Phone
- (734) 647-5680
- NPI assigned
- May 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301511474 | MI | Primary |
Addresses
Primary practice location
3055 Plymouth Rd Ste 202
Ann Arbor, MI 48105-3208
Mailing address
13699 E Old US Highway 12
Chelsea, MI 48118-9664
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210623002048 | MI | Order and Referring Only - Pediatric Medicine | 8628479060 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301511474 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Care of Chelsea, PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- kelly.katona.1@33161.direct.athenahealth.com
- https://api.platform.athenahealth.com/3566/brand/1/csg/1/fhir/r4
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Chelsea, MI
- NPI 1447321955
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": "1721260800000",
"number": "1609440916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13699 E OLD US HIGHWAY 12",
"city": "CHELSEA",
"state": "MI",
"postal_code": "481189664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3055 PLYMOUTH RD STE 202",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481053208",
"telephone_number": "734-647-5680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATONA",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-20",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301511474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.