Individual provider Active NPI

Lucia A Kemennu, M.D.

  • Internal Medicine Physician
  • Farmington Hills, MI
National Provider Identifier
1841208196
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301051164 Issued in MI
Practice address
27555 Farmington Rd
Suite 120
Farmington Hills, MI 48334-3376
Phone
(248) 477-5608
Fax
(248) 427-0010
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301051164 MI Primary
Pediatrics Physician 208000000X 4301051164 MI

Addresses

Primary practice location

27555 Farmington Rd
Suite 120
Farmington Hills, MI 48334-3376

Mailing address

27555 Farmington Rd
Suite 120
Farmington Hills, MI 48334-3376
Phone (248) 477-5608

Other identifiers 2

IdentifierTypeStateIssuer
P00857637OtherMIRAILROAD MEDICARE
3053204MedicaidMI

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301051164MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: luciakemennu@hhpc.allscriptsdirect.net

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1841208196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27555 FARMINGTON RD",
            "address_2": "SUITE 120",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343376",
            "telephone_number": "248-477-5608",
            "fax_number": "248-427-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27555 FARMINGTON RD",
            "address_2": "SUITE 120",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343376",
            "telephone_number": "248-477-5608",
            "fax_number": "248-427-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMENNU",
        "first_name": "LUCIA",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301051164",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301051164",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00857637",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3053204",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.