Individual provider Active NPI

Kimberly Suzanne Haines, FNP

  • Family Nurse Practitioner
  • Three Rivers, MI
National Provider Identifier
1669962577
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704276873 Issued in MI
Practice address
601 S US Highway 131
Three Rivers, MI 49093-8831
Phone
(269) 286-7070
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704276873 MI Primary

Addresses

Primary practice location

601 S US Highway 131
Three Rivers, MI 49093-8831

Mailing address

601 John St # 42
Kalamazoo, MI 49007-5341
Phone (269) 341-6417

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180709001245 MI Practitioner - Nurse Practitioner 8022364959 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

5623 Gull Rd
Suite 500
Kalamazoo, MI 49048-1097
Phone (269) 775-8031

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704276873MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Services of Southwest Michigan PC Current Accepting new patients
Patholgy Services of Kalamazoo, PC Current Accepting new patients
Southwestern Michigan Emergency Services, PC CurrentSince Oct 16, 2019 Accepting new patients
Bronson Methodist Hospital CurrentSince Jun 24, 2018 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

300 North Ave
Battle Creek, MI 49017
Phone (269) 966-8000

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

5623 Gull Rd
Ste 500
Kalamazoo, MI 49048
Phone (269) 775-8031

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

601 John St
Ste M-170
Kalamazoo, MI 49007
Phone (269) 343-3939

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

601 John St
#2
Kalamazoo, MI 49007

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

601 S US Highway 131
Three Rivers, MI 49093
Phone (269) 286-7070

Interoperability endpoints

  • Direct secure messaging: kimberly.haines.p1@direct.gracehealthmi.nextgenshare.com
  • Direct secure messaging: direct@direct.bronsonhg.org
  • Direct secure messaging: khaines2360@direct.bronsonhg.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1669962577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST # 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S US HIGHWAY 131",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938831",
            "telephone_number": "269-286-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "KIMBERLY",
        "middle_name": "SUZANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704276873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

Verify at the official NPI Registry.