Active NPI
Arthur B Kellert, DPM
- Podiatrist
- Wayne, MI
National Provider Identifier
1790715282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- AK000685
- Practice address
- 35519 Michigan Ave
Wayne, MI 48184 - Phone
- (734) 721-0561
- Fax
- (734) 721-7583
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | AK000685 | MI | Primary |
Addresses
Primary practice location
35519 Michigan Ave
Wayne, MI 48184
Mailing address
35519 E Michigan Ave
Wayne, MI 48184-1682
Phone (734) 721-0561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1074377 | Medicaid | MI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AK000685 | MI | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209600000000",
"number": "1790715282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35519 E MICHIGAN AVE",
"city": "WAYNE",
"state": "MI",
"postal_code": "481841682",
"telephone_number": "734-721-0561",
"fax_number": "734-721-7583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35519 MICHIGAN AVE",
"city": "WAYNE",
"state": "MI",
"postal_code": "48184",
"telephone_number": "734-721-0561",
"fax_number": "734-721-7583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLERT",
"first_name": "ARTHUR",
"middle_name": "B",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2008-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "AK000685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1074377",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.