Active NPI
Kenny Jefferson
- Registered Nurse
- Romulus, MI
National Provider Identifier
1982524161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704294272
- Practice address
- 7956 Surrey Dr
Romulus, MI 48174-6332 - Phone
- (404) 964-7776
- NPI assigned
- Jul 17, 2026
- Last updated
- Jul 17, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704294272 | MI | Primary |
Addresses
Primary practice location
7956 Surrey Dr
Romulus, MI 48174-6332
Mailing address
7956 Surrey Dr
Romulus, MI 48174-6332
Phone (404) 964-7776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784246400000",
"number": "1982524161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7956 SURREY DR",
"city": "ROMULUS",
"state": "MI",
"postal_code": "481746332",
"telephone_number": "404-964-7776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7956 SURREY DR",
"city": "ROMULUS",
"state": "MI",
"postal_code": "481746332",
"telephone_number": "404-964-7776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERSON",
"first_name": "KENNY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-07-17",
"last_updated": "2026-07-17",
"certification_date": "2026-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704294272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Romulus, MI
- Steven P Jaffe, DDS
- Reginald Benjamin James
- Jameschorehelpprovideragencyllc
- Sameer M Jariwala, PHARMACIST
- Ammar Jasim
- Jeremiah M. Shaft D.C. P.L.L.C. (True Health Chiropractic)
- Anna Jonascu-Devine, M.D.
- Clarinda Ann Jones-Washington, FNP
- Joy Hix Pharmacy LLC (Joy Hix Pharmacy)
- Thomas C Kackmeister, PTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.