Individual provider Active NPI

Anne Marie McKune, NP

  • Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1982652483
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704152445 Issued in MI
Practice address
813 E Michigan Ave
Jackson, MI 49201-2401
Phone
(517) 787-6001
Fax
(517) 782-2062
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704152445 MI Primary

Addresses

Primary practice location

813 E Michigan Ave
Jackson, MI 49201-2401

Mailing address

Department 272801
PO Box 67000
Detroit, MI 48267-0001
Phone (517) 841-6913

Other identifiers 2

IdentifierTypeStateIssuer
500024273OtherMIRR MEDICARE
4394905MedicaidMI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address amckune455911@directhfhs.org
Direct Messaging Address amckune455911@directhfhs.org
Direct Messaging Address amckune455911@directhfhs.org

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Pathology Current Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1982652483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT 272801",
            "address_2": "PO BOX 67000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670001",
            "telephone_number": "517-841-6913",
            "fax_number": "517-841-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012401",
            "telephone_number": "517-787-6001",
            "fax_number": "517-782-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKUNE",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704152445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500024273",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4394905",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amckune455911@directhfhs.org",
            "affiliation": "N",
            "address_1": "1 S Jackson Sq Ste 102",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492012383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amckune455911@directhfhs.org",
            "affiliation": "N",
            "address_1": "1 S Jackson Sq Ste 102",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492012383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amckune455911@directhfhs.org",
            "affiliation": "N",
            "address_1": "1 S Jackson Sq Ste 102",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492012383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.