Kaytlin Mather, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704325672 Issued in MI

Practice address

19229 Mack Ave Ste 24
Grosse Pointe Woods, MI 48236-2857

Phone

(313) 884-5522

NPI assigned

Oct 26, 2022

Last updated

Oct 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaytlin Shipley Former name

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmather1140490@direct.hfhs.org

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.

• Henry Ford Health St. John Hospital

  dba St John North Shores Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment Care Compare group NPD
• Henry Ford Health St. John Hospital

  dba Henry Ford St John Hospital

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1912965088
  NPD
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1730806001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15563 GOLDEN DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480443164",
            "telephone_number": "248-835-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE STE 24",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362857",
            "telephone_number": "313-884-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHER",
        "first_name": "KAYTLIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704325672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYTLIN",
            "last_name": "SHIPLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pennie Marie Marko, CRNA
• Kayla Marlow
• Nathan E Maroney, LLPC
• Angela Martin
• Marivic D Massand, M.D.
• Jaylun Andrew Mathis
• Matt Ptaszkiewicz MD PC
• Grace Kelly Matt
• Jada Matthews, BS
• Paul Holmes Mattman, DDS

• Family Nurse Practitioner in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.