Kenna Mackenzie Clements

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

5333 McAuley Dr RM 2110
Ypsilanti, MI 48197-1097

Phone

(734) 712-3967

NPI assigned

Mar 28, 2023

Sex

Female

Sole proprietor

Yes

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: kclements2695035@direct.trinity-health.org

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1962106583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4291 HOMESTEAD DR",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488439454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR RM 2110",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971097",
            "telephone_number": "734-712-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "KENNA",
        "middle_name": "MACKENZIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lara R Clary-Lantis, D.O.
• Darlene Clay
• Robert K Cleary, MD
• Nichole Cleavenger, CRNA
• Charmisha Clegg
• Cleveland Home Care, Inc.
• Eriona Cleveland
• Richard J Clews, ANP
• Amy Cline
• Zachary Clipper II

• Student in an Organized Health Care Education/Training Program in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.