Kaitlyn Sue Wixson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

330 W Michigan Ave
Jackson, MI 49201-2121

Phone

(517) 787-7920

NPI assigned

Jul 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Family HealthGroup PAC ID 4587574421, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwixson719963@direct.hfhs.org

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.

• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1780784439
  Medicare reassignment Care Compare group NPD
• Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
  • NPI 1710764410
  NPD

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1629621925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 CHURCHILL RD",
            "city": "LESLIE",
            "state": "MI",
            "postal_code": "492519794",
            "telephone_number": "517-392-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012121",
            "telephone_number": "517-787-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIXSON",
        "first_name": "KAITLYN",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Pok Wisely, MD
• Walter A. Witherspoon, CRNA
• Lou Ann Withington
• Scott Witte
• Ivette M Witzel, MD
• Janice Sue Wohlgemuth, PT
• Melva Lynn Wolcott, CNP
• Kalib Wolf
• Wolfgang Seiber
• Daniel Webster Christian Wood, LMSW

• Professional Counselor in Jackson, MI
• Providers in Jackson, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.