Kimberly A Radakovic, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

4704247442 Issued in MI

Practice address

1941 Graefield Rd
Birmingham, MI 48009-5849

Phone

(586) 354-7967

NPI assigned

Jun 9, 2021

Last updated

Jun 9, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1649847450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 GRAEFIELD RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480095849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 GRAEFIELD RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480095849",
            "telephone_number": "586-354-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADAKOVIC",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704247442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gq7618@wayne.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1200 N Telegraph Rd # 32East",
            "city": "Pontiac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483411032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Registered Nurse in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.