Kelly Daneil-Marie Jefferson, BS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

12800 E Warren Ave
Detroit, MI 48215-2061

Phone

(877) 242-4140

NPI assigned

Sep 11, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1757548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1841171295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 W 9 MILE RD APT 217",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755909",
            "telephone_number": "313-208-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152061",
            "telephone_number": "877-242-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "KELLY",
        "middle_name": "DANEIL-MARIE",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-11",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jefferson Medical Industrial Clinic PC
• Jefferson RX LLC
• Alyce L Jefferson
• Candace Jefferson
• Jasmine Shanice Jefferson
• Klyn Jefferson
• Lecole Jefferson
• Linda Teresa Jefferson
• Rochelle M Jefferson, LMSW
• Sierra Nicole Jefferson

• Case Manager/Care Coordinator in Detroit, MI
• Providers in Detroit, MI by specialty
• Case Manager/Care Coordinator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.