Jeremy Kallenbach, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301063038 Issued in MI

Practice address

24681 Northwestern Hwy
Ste. 100
Southfield, MI 48075-2305

Phone

(248) 352-2000

Fax

(248) 324-1477

NPI assigned

Jan 18, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Embrace Home Health Physicians

  • Family Medicine Physician
  • Southfield, MI
  • NPI 1598779282
  NPD (past)
• Embrace Home Physicians PLLC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1548704778
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1891775730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24681 NORTHWESTERN HWY",
            "address_2": "STE. 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752305",
            "telephone_number": "248-352-2000",
            "fax_number": "248-324-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24681 NORTHWESTERN HWY",
            "address_2": "STE. 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752305",
            "telephone_number": "248-352-2000",
            "fax_number": "248-324-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLENBACH",
        "first_name": "JEREMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301063038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4403817",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Linda-Jackman Kalis, PA-C
• Emily Kalisch
• Erin Elizabeth Kalka, LMFT
• Kenisha Kalka
• Hana Joy Kallabat, MD
• Kalypso Treatment Centers, PLLC
• Eliyahou Kam, MD
• Kumba F Kamara, N.P.
• Ivan Kamikovski, M.D.
• Gregory Kaminski

• Family Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.