Individual provider Active NPI

Kimberlee Denise Robinson, RN

  • Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1982285938
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704198158 Issued in MI
Practice address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone
(313) 966-3300
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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 4704198158 MI
Nurse Practitioner 363L00000X 4704198158 MI Primary

Addresses

Primary practice location

6071 W Outer Dr
Detroit, MI 48235-2624

Mailing address

6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-3300

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
I20211201001754 MI Practitioner - Nurse Practitioner 6406246768 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Medical Group PLLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

17177 N Laurel Park Dr
Ste 439
Livonia, MI 48152

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1982285938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "KIMBERLEE",
        "middle_name": "DENISE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704198158",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704198158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.