NPIMap

Individual provider Active NPI

Kristina Maria Wixon, D.O.

  • Family Medicine Physician
  • Shelby TWP, MI
National Provider Identifier
1619358793
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101021985 Issued in MI
Practice address
6000 24 Mile Rd
Shelby TWP, MI 48316-3201
Phone
(586) 677-3310
Fax
(586) 677-3326
NPI assigned
Jun 15, 2015
Last updated
Jun 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101021985 MI Primary

Addresses

Primary practice location

6000 24 Mile Rd
Shelby TWP, MI 48316-3201

Mailing address

27450 Schoenherr Rd Ste 400
Warren, MI 48088-6684
Phone (586) 582-7550

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
I20170228000549 MI Practitioner - Family Practice 3072819721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partners in Family Medicine, PLLCGroup PAC ID 4688769516, 3 clinicians

Practice addresses (Care Compare)

6000 24 Mile Rd
Shelby Township, MI 48316-3201
Phone (586) 884-6702

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Family Medicine, PLLC Family Medicine CurrentSince Aug 1, 2018 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

6000 24 Mile Rd
Shelby Township, MI 48316
Phone (586) 677-3310

8180 26 Mile Rd
Ste 100
Shelby Township, MI 48316
Phone (586) 336-7321

Interoperability endpoints

  • Direct secure messaging: kristinawixon@pifmedic.allscriptsdirect.net
  • Direct secure messaging: kwixon986216@direct.hfhs.org

Organizations & group practices 2

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 8

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1619358793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27450 SCHOENHERR RD STE 400",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886684",
            "telephone_number": "586-582-7550",
            "fax_number": "586-582-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 24 MILE RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483163201",
            "telephone_number": "586-677-3310",
            "fax_number": "586-677-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIXON",
        "first_name": "KRISTINA",
        "middle_name": "MARIA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101021985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

Verify at the official NPI Registry.