Individual provider Active NPI

Erin Kiley

  • Family Nurse Practitioner
  • Madison Heights, MI
National Provider Identifier
1720748767
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704309838 Issued in MI
Practice address
30581 Stephenson Hwy
Madison Heights, MI 48071-1610
Phone
(248) 589-1770
NPI assigned
Dec 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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 4704309838 MI Primary

Addresses

Primary practice location

30581 Stephenson Hwy
Madison Heights, MI 48071-1610

Mailing address

30581 Stephenson Hwy
Madison Heights, MI 48071-1610
Phone (248) 589-1770

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
I20220309000994 MI Practitioner - Nurse Practitioner 9133514128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pure Psychiatry of Michigan PLLCGroup PAC ID 1254741283, 102 clinicians

Practice addresses (Care Compare)

2422 Jolly Rd
Suite 100a
Okemos, MI 48864-3690
Phone (517) 853-1358

3031 Commerce Dr
Suite a
Fort Gratiot, MI 48059-4515
Phone (810) 292-0557

34841 Veterans PLZ
Wayne, MI 48184-1733
Phone (313) 292-7640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704309838MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical P C CurrentSince Dec 15, 2021 Accepting new patients
Pure Psychiatry of Michigan PLLC CurrentSince Jul 17, 2023 Accepting new patients

Locations

5715 Bella Rosa Blvd
Ste 200
Clarkston, MI 48348
Phone (248) 657-4639

3031 Commerce Dr
Ste A
Fort Gratiot, MI 48059
Phone (810) 292-0557

30581 Stephenson Hwy
Madison Hts, MI 48071
Phone (248) 234-3101

2422 Jolly Rd
Ste 100A
Okemos, MI 48864
Phone (517) 853-1358

13636 Dix Toledo Rd
Southgate, MI 48195
Phone (313) 283-2262

34841 Veterans Plz
Wayne, MI 48184
Phone (313) 292-7640

Interoperability endpoints

  • Direct secure messaging: purepsychiatryofmichigan.erinkiley@153418.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1720748767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30581 STEPHENSON HWY",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711610",
            "telephone_number": "248-589-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30581 STEPHENSON HWY",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711610",
            "telephone_number": "248-589-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILEY",
        "first_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704309838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

Verify at the official NPI Registry.