Individual provider Active NPI

Lorenz P Kielhorn, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Kalamazoo, MI
National Provider Identifier
1891816427
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
4301042187 Issued in MI
Practice address
401 Howard St
Kalamazoo, MI 49001-2748
Phone
(269) 344-4458
Fax
(269) 344-4459
NPI assigned
Apr 2, 2007
Last updated
Oct 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 4301042187 MI Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301042187 MI

Addresses

Primary practice location

401 Howard St
Kalamazoo, MI 49001-2748

Mailing address

401 Howard St
Kalamazoo, MI 49001-2748
Phone (269) 344-4458

Other identifiers 1

IdentifierTypeStateIssuer
LK042187OtherMIBLUE CROSS BLUE SHIELD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120910000612 MI Practitioner - Addiction Medicine 5496903825 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301042187MIMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Clinical Services II LLC Addiction Medicine CurrentSince Sep 26, 2006 Accepting new patients
Victory Clinical Services Battle Creek LLC CurrentSince Oct 20, 2017 Accepting new patients

Locations

4218 W Western Ave
South Bend, IN 46619
Phone (574) 233-1524

842 Columbia Ave E
Ste 2
Battle Creek, MI 49014
Phone (269) 753-1710

401 Howard St
Kalamazoo, MI 49001
Phone (269) 344-4458

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1891816427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOWARD ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490012748",
            "telephone_number": "269-344-4458",
            "fax_number": "269-344-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOWARD ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490012748",
            "telephone_number": "269-344-4458",
            "fax_number": "269-344-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELHORN",
        "first_name": "LORENZ",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MI",
            "license": "4301042187",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301042187",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "LK042187",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.