Individual provider Active NPI

Kendra Niemi, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rochester Hills, MI
National Provider Identifier
1891087714
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704259968 Issued in MI
Practice address
441 S Livernois Rd
Suite 205
Rochester Hills, MI 48307-2584
Phone
(248) 608-8800
NPI assigned
May 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704259968 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704259968 MI Primary

Addresses

Primary practice location

441 S Livernois Rd
Suite 205
Rochester Hills, MI 48307-2584

Mailing address

441 S Livernois Rd
Suite 205
Rochester Hills, MI 48307-2584
Phone (248) 608-8800

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
I20111012000398 MI Practitioner - Nurse Practitioner 2567634751 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704259968MIMDRegistered Nurse

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": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319760000000",
    "number": "1891087714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 S LIVERNOIS RD",
            "address_2": "SUITE 205",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072584",
            "telephone_number": "248-608-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 S LIVERNOIS RD",
            "address_2": "SUITE 205",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072584",
            "telephone_number": "248-608-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMI",
        "first_name": "KENDRA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704259968",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704259968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.