Individual provider Active NPI

Daniel Kueppers

  • General Practice Registered Nurse
  • Canton, MI
National Provider Identifier
1730685132
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
4704138722 Issued in MI
Practice address
3505 Denton Rd
Canton, MI 48188-2107
Phone
(734) 340-1313
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 4704138722 MI Primary

Addresses

Primary practice location

3505 Denton Rd
Canton, MI 48188-2107

Mailing address

44450 Pinetree Dr Ste 203
Plymouth, MI 48170-3869
Phone (734) 207-8316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704138722MIMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Medical Staffing Past Accepting new patients

Organizations & group practices 1

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1730685132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44450 PINETREE DR STE 203",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703869",
            "telephone_number": "734-207-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 DENTON RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882107",
            "telephone_number": "734-340-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEPPERS",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MI",
            "license": "4704138722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; 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.