Individual provider Active NPI

Kristen Marie Kubik, NP

  • Family Nurse Practitioner
  • Plymouth, MI
National Provider Identifier
1710543863
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0039097 Issued in OH
Practice address
13970 Oakland CT
Plymouth, MI 48170-5292
Phone
(810) 471-2399
NPI assigned
May 14, 2019
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704299150 MI
Family Nurse Practitioner 363LF0000X APRN.CNP.0039097 OH Primary

Addresses

Primary practice location

13970 Oakland CT
Plymouth, MI 48170-5292

Mailing address

13970 Oakland CT
Plymouth, MI 48170-5292
Phone (810) 471-2399

Other identifiers 1

IdentifierTypeStateIssuer
4704299150OtherMINP LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristenk@missionofhope.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210429002822 NC Practitioner - Nurse Practitioner 4284043456 Reassigns benefits to 2 organizations
I20250925002201 OH Practitioner - Nurse Practitioner 4284043456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Urgent Care, LLCGroup PAC ID 3971985607, 109 clinicians

Practice addresses (Care Compare)

16601 Chagrin Blvd
Shaker Heights, OH 44120-3719
Phone (216) 727-2010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704299150MIMDFamily Nurse Practitioner
APRN.CNP.0039097OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Urgent Care, LLC CurrentSince Sep 8, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 29, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 29, 2021 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
University Hospitals Urgent Care, LLC CurrentSince Sep 8, 2025 Accepting new patients
Arboretum Urgent Care Center CurrentSince Mar 29, 2021 Accepting new patients

Locations

1825 Highway 34 E
Ste 1200
Newnan, GA 30265
Phone (770) 502-2112

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

231 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 304-6400

5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

3909 Orange Pl
Ste 2100
Beachwood, OH 44122
Phone (216) 896-1800

16601 Chagrin Blvd
Shaker Heights, OH 44120
Phone (216) 727-2010

Interoperability endpoints

  • Direct secure messaging: kkubik541124@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: kristen.kubik.1@30520.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1710543863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13970 OAKLAND CT",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481705292",
            "telephone_number": "810-471-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13970 OAKLAND CT",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481705292",
            "telephone_number": "810-471-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIK",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704299150",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0039097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "4704299150",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristenk@missionofhope.com",
            "affiliation": "N",
            "endpointDescription": "work email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "can be used for any work correspondence needed",
            "address_1": "13970 Oakland Ct",
            "city": "Plymouth",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481705292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.