Individual provider Active NPI

Kristen Kennedy, NP

  • Family Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1992357883
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704306531 Issued in MI
Practice address
1200 Sixth St Ste 200
Traverse City, MI 49684-2369
Phone
(231) 935-5800
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704306531 MI Primary

Addresses

Primary practice location

1200 Sixth St Ste 200
Traverse City, MI 49684-2369

Mailing address

1200 Sixth St Ste 200
Traverse City, MI 49684-2369
Phone (231) 935-5800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkennedy@direct.mhc.net

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
I20200211000643 MI Practitioner - Nurse Practitioner 8820424872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center AlpenaGroup PAC ID 8527969922, 97 clinicians

Practice addresses (Care Compare)

1501 W Chisholm St
Alpena, MI 49707-1401

460 Long Rapids PLZ
Alpena, MI 49707-1442
Phone (989) 356-0141

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Group CurrentSince Dec 7, 2019 Accepting new patients
Munson Medical Group CurrentSince Dec 7, 2019 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Aug 1, 2022 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Aug 1, 2022 Accepting new patients
Mymichigan Medical Center Alpena Past Accepting new patients

Locations

2891 Momentum Pl
Chicago, IL 60689

460 Long Rapids Plz
Alpena, MI 49707
Phone (989) 356-0141

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

208 S State St
Ste A
Oscoda, MI 48750
Phone (989) 356-8089

205 S Bradley Hwy
Rogers City, MI 49779
Phone (989) 356-0141

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1200 Sixth St
Ste 200
Traverse City, MI 49684

Interoperability endpoints

  • Direct secure messaging: kkennedy127656@mymichiganhealth.midirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1992357883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-935-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-935-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KRISTEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704306531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkennedy@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1200 Sixth St Ste 200",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.