Sally Warda Kejbou, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704327329 Issued in MI

Practice address

615 Parkland Dr
Rochester Hills, MI 48307-3453

Phone

(248) 298-9549

NPI assigned

Dec 18, 2020

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oakland Infectious Disease Associates PCGroup PAC ID 2860455268, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Oakland Infectious Disease Associates PC

  • Infectious Disease Physician
  • Bloomfield Hills, MI
  • NPI 1528192275
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1679169163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 PARKLAND DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073453",
            "telephone_number": "248-298-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PARKLAND DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073453",
            "telephone_number": "248-298-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEJBOU",
        "first_name": "SALLY",
        "middle_name": "WARDA",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704327329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Renee Kastl, MD
• Lisa Kassab Kattula
• Meagan Keat, P.T.
• Ronald Douglas Keen II, ATC
• James Keener, MSW
• Paul S Keller, O.D.
• Brandelyn Rachael Kelly, MD
• Tamara Lynette Kelly, L.P.C
• Lindsey Anne Kennard, LPC
• Kelley Danielle Kennedy Whitehead, LMSW

• Gerontology Nurse Practitioner in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.