Kirk Allen Deherder, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704327543 Issued in MI

Practice address

1455 S Lapeer Rd Ste 100
Lake Orion, MI 48360-1468

Phone

(248) 693-3551

NPI assigned

Jan 5, 2021

Sex

Male

Sole proprietor

No

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

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orion Family Physicians PCGroup PAC ID 0143212712, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• Orion Family Physicians PC

  • Family Medicine Physician
  • Lake Orion, MI
  • NPI 1578627816
  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1164186946
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1871181875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 S LAPEER RD STE 100",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601468",
            "telephone_number": "248-693-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 S LAPEER RD STE 100",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601468",
            "telephone_number": "248-693-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHERDER",
        "first_name": "KIRK",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-05",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704327543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Emmett Deck III, O.D.
• Sarah Degnan, CPNP, CNM
• Dehaan Othodontics
• David Andrew Dehaan, D.D.S., M.S.
• Deborah Dehaan, D.D.S., M.S., P.C.
• Joanne Marie Dehetre, RPH
• Arden Delidow
• Jeffrey T Denio, PA-C
• Elorie Lilah Derderian
• Diana L. Cohen, D.O., P.C.

• Family Nurse Practitioner in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.