Kelly Hefferon (NPI# 1255474813, PAC ID# 1557388139) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1255474813 |
| PAC ID by PECOS | 1557388139 |
| Professional Enrollment ID | I20051102000422 |
| Full Name | Kelly Hefferon |
| Address |
21650 W 11 Mile Rd Suite 209 Southfield MI 48076-3777 |
| Gender | F |
| Credential | DO |
| Graduation Year | 1994 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | GENERAL PRACTICE, GERIATRIC MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230165 | ST JOHN HOSPITAL AND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 21650 W 11 Mile Rd, Suite 209, Southfield, MI 48076-3777 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Street Address |
21650 W 11 MILE RD SUITE 209 |
| City | SOUTHFIELD |
| State | MI |
| Zip | 48076-3777 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John William Finn | Hospice/palliative Care | Integrated Visiting Physician Solutions PC | 21650 W 11 Mile Rd, Suite 202, Southfield, MI 48076-3777 |
| Eric A Phillips | Family Medicine | Integrated Visiting Physician Solutions PC | 21650 W 11 Mile Rd, Suite 202, Southfield, MI 48076-3777 |
| Susan L Taylor | Clinical Social Worker | 21650 W 11 Mile Rd, Suite 206, Southfield, MI 48076-3777 | |
| Gary L Stano | Podiatry | Integrated Visiting Physician Solutions PC | 21650 W 11 Mile Rd, Suite 202, Southfield, MI 48076-3777 |
| Ayoub Sayeg | Plastic and Reconstructive Surgery | Integrated Visiting Physician Solutions PC | 21650 W 11 Mile Rd, Suite 202, Southfield, MI 48076-3777 |
| Richard Miles | Family Medicine | Integrated Visiting Physician Solutions PC | 21650 W 11 Mile Rd, Suite 202, Southfield, MI 48076-3777 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy M Bakalar | Nurse Practitioner | Carolyn E Guidot Md PC | 18161 W 13 Mile Rd, Suite E1, Southfield, MI 48076-1113 |
| Raka Mahajan | Allergy/immunology | Suresh Anne Md PC | 18161 W 13 Mile Rd C, Asthma Allergy and Immunology Center, Southfield, MI 48076-1113 |
| Lyle S Grant | Family Medicine | 18161 W 13 Mile Rd, Suite E3, Southfield, MI 48076-1113 | |
| Katherine R Shaw | Nurse Practitioner | Carolyn E Guidot Md PC | 18161 W 13 Mile Rd, Suite E1, Southfield, MI 48076-1113 |
| Rao S Botta | Allergy/immunology | Suresh Anne Md PC | 18161 W 13 Mile Rd C, Asthma Allergy and Immunology Center, Southfield, MI 48076-1113 |
| Suresh Anne | Allergy/immunology | Suresh Anne Md PC | 18161 W 13 Mile Rd C, Asthma Allergy and Immunology Center, Southfield, MI 48076-1113 |
| Iqbal A Nasir | General Practice | 18161 W 13 Mile Rd, D4, Southfield, MI 48076-1113 | |
| Carolyn Elaine Guidot | Internal Medicine | Carolyn E Guidot Md PC | 18161 W 13 Mile Rd, Suite E1, Southfield, MI 48076-1113 |
| Jennifer R Hankinson | Nurse Practitioner | Carolyn E Guidot Md PC | 18161 W 13 Mile Rd, E1, Southfield, MI 48076-1113 |
| Susan Hyde Bakker | Clinical Social Worker | Personal and Family Adjustment Center PC | 30555 Southfield Rd, Suite 510, Southfield, MI 48076-1221 |
| Find all physicians in zip 48076 | |||
| City | SOUTHFIELD |
| Zip Code | 48076 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | SOUTHFIELD + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Kelly Hefferon.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.