Kimberly Ann Dunleavy, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704289989 Issued in MI

Practice address

990 W Ann Arbor TRL Ste 210
Plymouth, MI 48170-6202

Phone

(734) 455-4600

Fax

(734) 455-5637

NPI assigned

Aug 6, 2015

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

• Kimberly Ann Keppen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kdunleavy386367@direct.hfhs.org
• Direct secure messaging: kdunleavy1509565@direct.trinity-health.org

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.

• Iha Health Services Corporation

  dba IHA Milan Primary Care

  • Family Medicine Physician
  • Milan, MI
  • NPI 1467509067
  NPD (past)

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1811373384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL STE 210",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706202",
            "telephone_number": "734-455-4600",
            "fax_number": "734-455-5637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15555 Northline Rd",
            "address_purpose": "LOCATION",
            "city": "Southgate",
            "state": "MI",
            "postal_code": "481951896",
            "country_code": "US",
            "telephone_number": "734-285-3090",
            "fax_number": "734-285-3095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNLEAVY",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704289989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KEPPEN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayla Midori Duldulao, BCBA, LBA
• Aaliyah Dumas
• Jennifer Nicole Dumouchelle, RN, LPN
• Itali Dunbar
• Theresa Dunbar, LLP
• Deborah Sue Dunn, NURSE PRACTITIONER
• Anthony Clark Dunning, B.S.
• David Duong
• Chris Dale Duplichen
• Jarred Dupree

• Pediatric Nurse Practitioner in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.