Active NPI
Kimberlee Ann Buzenberg, NP
- Nurse Practitioner
- Ann Arbor, MI
National Provider Identifier
1982712196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704160508
- Practice address
- 2215 Fuller Rd
Ann Arbor, MI 48105-2335 - Phone
- (734) 769-7100
- Fax
- (734) 769-7099
- NPI assigned
- Aug 28, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704160508 | MI | Primary |
Addresses
Primary practice location
2215 Fuller Rd
Ann Arbor, MI 48105-2335
Mailing address
602 Coolidge St
Plymouth, MI 48170-1927
Phone (734) 459-7035
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150706000409 | MI | Order and Referring Only - Nurse Practitioner | 5496935314 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982712196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 COOLIDGE ST",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481701927",
"telephone_number": "734-459-7035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 FULLER RD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481052335",
"telephone_number": "734-769-7100",
"fax_number": "734-769-7099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUZENBERG",
"first_name": "KIMBERLEE",
"middle_name": "ANN",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704160508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.