KYLE M FARR (NPI# 1144508904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144508904 |
| Entity Type | Individual |
| Full Name | KYLE M FARR |
| Credential | NP-C |
| Practice Address |
640 Starkweather St Ste C Plymouth MI 48170-1371 |
| Mailing Address |
1856 Tradition Dr Canton MI 48187-5808 |
| Practice Telephone | 7342592804 |
| Practice Fax Number | 7342592805 |
| Mailing Telephone | 2693528031 |
| Mailing Fax Number | 7342592805 |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2020-04-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704253005 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704253005 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | CAQH | 12304421 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2300 Haggerty Rd, Suite 1010, West Bloomfield, MI 483232184 | 2489269111 | 2489269112 |
| Street Address |
640 STARKWEATHER ST STE C |
| City | PLYMOUTH |
| State | MI |
| Zip Code | 48170-1371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1265075279 | Mast Enterprises | Home Health | 40800 Five Mile Rd Ste C, Plymouth, MI 48170 | 2019-10-22 |
| 1003470964 | Smiley Private Homecare LLC | Technician, Pathology | 1098 Ann Arbor Rd #249, Plymouth, MI 48170 | 2019-04-26 |
| 1275003832 | Atsalis Dental Excellence | Dentist | 690 South Main St, Plymouth, MI 48170 | 2018-11-27 |
| 1275003808 | Danielle Cefalo | Speech-Language Pathologist | 801 W. Ann Arbor Trail Suite 220, Plymouth, MI 48170 | 2018-11-27 |
| 1962987966 | Mindful Wellness Counseling, LLC | Social Worker | 9266 Northern Ave, Plymouth, MI 48170 | 2018-09-26 |
| 1972094027 | Plymouth Urgent Care Walk-in Clinic LLC | Clinic/Center | 1498 S Sheldon Rd, Plymouth, MI 48170 | 2018-05-24 |
| 1356843791 | Polaris Pharmacy Services of Michigan, LLC | Pharmacy | 9131 General Court, Plymouth, MI 48170 | 2018-03-01 |
| 1528569787 | Alcona Citizens for Health Inc | Clinic/Center | 101 S Union St Unit 101, Plymouth, MI 48170 | 2018-02-23 |
| 1073029484 | Holly Ann Haase | Technician/Technologist | 650 Church St, Plymouth, MI 48170 | 2017-12-20 |
| Find all providers in zip 48170 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710417852 | Lois Joyce Roberson | Nurse Practitioner | 1032 Us Highway 64 E, Plymouth, NC 27962-9215 | 2017-06-12 |
| 1407221013 | Teresa June Taylor | Nurse Practitioner | 320 Court St., Plymouth, MA 02360 | 2015-12-08 |
| 1730558313 | Kendra Broussard | Nurse Practitioner | 101 Court St Ste 8, Plymouth, MA 02360-8718 | 2015-09-24 |
| 1285043828 | Georgia T Foudy | Nurse Practitioner | 258 Plympton Rd, Plymouth, MA 02360-4644 | 2014-08-07 |
| 1629329867 | Erin Duff | Nurse Practitioner | 1919 Lake Ave Ste 104, Plymouth, IN 46563-7830 | 2012-09-27 |
| 1760731798 | Daniel D. Tanner | Nurse Practitioner | 105 Water St, Plymouth, IN 46563-2148 | 2012-09-06 |
| 1649372608 | Laura Ann Dansel | Nurse Practitioner | 595 Forest Ave, Suite 7a, Plymouth, MI 48170-1775 | 2006-09-01 |
| 1659336303 | Catherine T. Milne | Nurse Practitioner | 204 Keegan Rd, Plymouth, CT 06782-2608 | 2006-04-18 |
| 1881686996 | Janet Marie Lincoln | Nurse Practitioner | 8 Pilgrim Hill Rd, Minuteclinic/target Primary Practice 8 Pilgrim Hill Rd, Plymouth, MA 02360-6123 | 2005-08-16 |
| 1548821622 | Ryan Heisler | Nurse Practitioner | 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 | 2019-06-27 |
| Find all providers in PLYMOUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.