Kathryn Hornick

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901601834 Issued in MI

Practice address

23941 John R Rd
Hazel Park, MI 48030-1416

Phone

(248) 547-2055

NPI assigned

Jun 21, 2023

Last updated

Jul 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• E & N, John R Practice PLLC

  • General Practice Dentistry
  • Hazel Park, MI
  • NPI 1528826757
  NPD
• Irwin Goodman

  • General Practice Dentistry
  • Hazel Park, MI
  • NPI 1205377694
  NPD (past)

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1699450247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23941 JOHN R RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301416",
            "telephone_number": "248-547-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23941 JOHN R RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301416",
            "telephone_number": "248-547-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNICK",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "2901601834",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hazel Park Pharmacy Inc (Hazel Park Pharmacy)
• Hazel Park Primary Care LLC (Neu Hope)
• Hazel Park Urgent Care PLLC
• Hazelwood Pharmacy LLC (Hazelwood Pharmacy)
• Gina Marie Hodgson
• Jessica Howard, PA-C
• HP Limited Dividend Housing Association LLC (Baldwin House Hazel Park)
• Emma Hubbard
• Godwin Ilonze
• Irwin Goodman

• General Practice Dentistry in Hazel Park, MI
• Providers in Hazel Park, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.