Jessica Kenaya, MSN, RN, CPNP-PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704267272 Issued in MI

Practice address

3555 W 13 Mile Rd
Suite 605
Royal Oak, MI 48073-6710

Phone

(248) 551-3302

Fax

(248) 551-1350

NPI assigned

Jan 15, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jessica Mansour Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: jkenaya24325@direct.beaumont.edu

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1689096331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 W 13 MILE RD",
            "address_2": "SUITE 605",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-3302",
            "fax_number": "248-551-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-3284",
            "fax_number": "248-898-9189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENAYA",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "MSN, RN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704267272",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704267272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkenaya24325@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MANSOUR",
            "prefix": "MS.",
            "credential": "MSN, RN, CPNP-PC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela Kello, FNP-BC
• Hannah Kelly-McFarland
• Shane Thomas Kelly
• Stephanie Josephine Kelly, D.C.
• Ryan Kelsch, DO
• Ada L Kendall, MD
• Aidan Kennedy, MD
• Nancy Sue Kennedy, RD
• Timothy Raymond Kennedy, M.D.
• Kenneth Goldman, MD PC

• Nurse Practitioner in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.