Individual provider Active NPI

Kimberly Sarah Woolsey McDowell, DNP, MSN, FNP-BC, RN

  • Family Nurse Practitioner
  • Grosse Pointe, MI
National Provider Identifier
1861107641
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704344356NSA220O6 Issued in MI
Practice address
17000 Kercheval Ave Ste 215
Grosse Pointe, MI 48230-1572
Phone
(313) 882-5777
Fax
(313) 882-5776
NPI assigned
Jan 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704344356NSA220O6 MI Primary

Addresses

Primary practice location

17000 Kercheval Ave Ste 215
Grosse Pointe, MI 48230-1572

Mailing address

17000 Kercheval Ave Ste 215
Grosse Pointe, MI 48230-1572
Phone (313) 882-5777

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230912001335 MI Practitioner - Nurse Practitioner 3971967829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704344356NSA220O6MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Aug 8, 2023 Accepting new patients
Shauna Ryder Diggs MD PC CurrentSince Jan 22, 2023 Accepting new patients

Locations

17000 Kercheval Ave
Ste 215
Grosse Pointe Park, MI 48230
Phone (313) 822-5777

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 2

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": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1861107641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 KERCHEVAL AVE STE 215",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301572",
            "telephone_number": "313-882-5777",
            "fax_number": "313-882-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 KERCHEVAL AVE STE 215",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301572",
            "telephone_number": "313-882-5777",
            "fax_number": "313-882-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "KIMBERLY",
        "middle_name": "SARAH WOOLSEY",
        "name_prefix": "Dr.",
        "credential": "DNP, MSN, FNP-BC, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704344356NSA220O6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe, MI

Sources for this page

Verify at the official NPI Registry.