Individual provider Active NPI

Dena Kenney

  • Registered Nurse
  • Clarkston, MI
National Provider Identifier
1992294516
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704278741 Issued in MI
Practice address
9151 Fox Hollow Rd
Clarkston, MI 48348-1966
Phone
(248) 961-7060
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704278741 MI Primary

Addresses

Primary practice location

9151 Fox Hollow Rd
Clarkston, MI 48348-1966

Mailing address

9151 Fox Hollow Rd
Clarkston, MI 48348-1966

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
I20241228000188 MI Practitioner - Nurse Practitioner 7810424041 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC CurrentSince Oct 24, 2024 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Oct 24, 2024 Accepting new patients

Locations

20555 Victor Pkwy
#3A
Livonia, MI 48152

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

Organizations & group practices 2

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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1992294516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9151 FOX HOLLOW RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483481966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9151 FOX HOLLOW RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483481966",
            "telephone_number": "248-961-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "DENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704278741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.