Mid-Mitten Pediatric Psychiatry

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

Legal business name

MID-MITTEN PEDIATRIC PSYCHIATRY

Practice address

1660 Haslett Rd Ste 1
Haslett, MI 48840-8469

Phone

(517) 347-8420

Fax

(517) 347-8420

NPI assigned

Feb 12, 2021

Last updated

Feb 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samantha Fugate Kennedy, DONPI 1154760312

Title

Physician/Owner

Phone

(517) 347-8420

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samantha Fugate Kennedy, D.O.

  • Child & Adolescent Psychiatry Physician
  • Haslett, MI
  • NPI 1154760312
  NPD Authorized official

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1902499767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 HASLETT RD STE 1",
            "city": "HASLETT",
            "state": "MI",
            "postal_code": "488408469",
            "telephone_number": "517-347-8420",
            "fax_number": "517-347-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 HASLETT RD STE 1",
            "city": "HASLETT",
            "state": "MI",
            "postal_code": "488408469",
            "telephone_number": "517-347-8420",
            "fax_number": "517-347-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MITTEN PEDIATRIC PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "FUGATE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "517-347-8420",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Mary McCarthy, P.T.
• Jamie Lynn McKenzie, O.D.
• Aaron Henry Megazzi, D.P.T.
• Barbara Louise Merrill, DO
• Michigan Caregiver Partners LLC
• Jacqueline Carinne Mirate, D.O.
• Elizabeth Montemayor
• Abbey L. Moran Moran, CRC
• Morrow-Morrow DDS PC
• Morrow-Morrow DDS PC

• Child & Adolescent Psychiatry Physician in Haslett, MI
• Providers in Haslett, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.