DR. NICOLE A KENNEDY (NPI# 1679782395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679782395 |
| Entity Type | Individual |
| Full Name | DR. NICOLE A KENNEDY |
| Credential | MD |
| Practice Address |
6777 W Maple Rd Department of Vascular Surgery West Bloomfield MI 48322-3013 |
| Practice Telephone | 2483253087 |
| Practice Fax Number | 2483250071 |
| Mailing Telephone | 2483253087 |
| Mailing Fax Number | 2483250071 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-04-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 4301081948 | MI | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
4301081948 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427569987 | Nicole Elizabeth Kennedy | Pharmacist | 343 Pinewood Rd, Sumter, SC 29150-5442 | 2017-10-23 |
| 1609231174 | Nicole L Kennedy | Specialist | 5225 Sandusky Rd, Lima, OH 45801-8734 | 2015-12-28 |
| 1730412958 | Nicole Dyan Kennedy | Physician Assistant | 850 East Harvard Avenue, Suite 285, Denver, CO 80210 | 2009-09-08 |
| 1528145398 | Nicole Celeste Kennedy | Physical Therapist | 612 W Carolina Ave, Hartsville, SC 29550-4410 | 2006-11-01 |
| 1649232372 | Nicole Shuff Kennedy | Nurse Practitioner | 560 N Cleveland Ave, Westerville, OH 43082-9105 | 2006-04-06 |
| 1659996783 | Nicole Kennedy | Student in an Organized Health Care Education/Training Program | 399 Lincoln Rd, Walpole, MA 02081-1218 | 2020-06-15 |
| 1568942415 | Nicole Rose Kennedy | Student in an Organized Health Care Education/Training Program | 1014 Main Street, Vancouver, WA 98660 | 2018-08-20 |
| 1164913489 | Nicole Marie Kennedy | Counselor | 221 Hamilton St, Ogdensburg, NY 13669-1707 | 2018-05-22 |
| 1295236842 | Nicole Jean Kennedy | Counselor | 4410 Arapahoe Ave Ste 205, Boulder, CO 80303-1155 | 2018-02-27 |
| 1487169371 | Nicole Kennedy | Chiropractor | 5253 Ne Sandy Blvd, Portland, OR 97213-2562 | 2017-12-13 |
| Street Address |
6777 W MAPLE RD DEPARTMENT OF VASCULAR SURGERY |
| City | WEST BLOOMFIELD |
| State | MI |
| Zip Code | 48322-3013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497754816 | Lynne Camille Gafford | Nurse Practitioner | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2005-07-18 |
| 1740891639 | Teia Lee Irwin | Nurse Practitioner | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-08-13 |
| 1154947323 | Jaykumar Shah | Nurse Practitioner | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-06-23 |
| 1669098174 | Isaac Michael Peruski | Internal Medicine | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-06-20 |
| 1609490689 | Jessica Sassine Akl | Physician Assistant | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-06-04 |
| 1952922684 | Marie Giuseppa Diponio-hohl | Registered Nurse | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-05-05 |
| 1679194542 | Betsy Thomas | Registered Nurse | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-05-02 |
| 1952922841 | Hiba Nabil Issa | Pharmacist | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2020-05-01 |
| 1427692607 | Jenna E Buchman | Nurse Practitioner | 6777 W Maple Rd, West Bloomfield, MI 48322-3013 | 2019-10-31 |
| 1558911412 | Anne Renee Adelson | Physician Assistant | 6777 W Maple Rd, West Bloomfield, MI 48322-3031 | 2019-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483492 | Life Saver Home Health, LLC | Home Health | 6436 Silverbrooke, West Bloomfield, MI 48322 | 2020-10-06 |
| 1316557374 | Gabrielle Benaderet | Speech-Language Pathologist | 6548 Heritage, West Bloomfield, MI 48322 | 2020-08-05 |
| 1437774197 | Madeline Gail Tenenbaum | Social Worker | 6800 W. Maple Rd., West Bloomfield, MI 48322 | 2020-06-09 |
| 1639705676 | Stephanie Cole | Social Worker | 5749 Crossgate, West Bloomfield, MI 48322 | 2020-03-22 |
| 1407409709 | Laura Elizabeth Large | Social Worker | Couseling Associates, Inc., 6960 Orchard Lake Rd. Ste. 100, W. Bloomfield, MI 48322 | 2019-07-17 |
| 1144796533 | Jaleesa Davis | Home Health Aide | 6436 Silverbrook W, West Bloomfield, MI 48322 | 2018-10-23 |
| 1912484411 | Mjl Therapy Pllc | Clinic/Center | 5745 West Maple Road Suite 213, West Bloomfield, MI 48322 | 2018-07-26 |
| 1396247847 | Martha Gomez-pedraza | Physical Therapist | 6200 Orchard Lake Rd - Suite Ll9, West Bloomfield, MI 48322 | 2018-03-01 |
| 1659872174 | Jennifer Marie O'connor | Physical Therapist | Beaumont Medical Center West Bloomfield, 6900 Orchard Lake Rd., Suite Ll09, West Bloomfield, MI 48322 | 2018-02-21 |
| 1851890834 | Naomi Marie Lang | Physical Therapy Assistant | 6535 Drake Rd. West, Bloomfield Township, MI 48322 | 2018-02-06 |
| Find all providers in zip 48322 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770036147 | Joseph P. Elliott Jr. | Surgery | 3282 Woodview Lake Rd, West Bloomfield, MI 48323-3570 | 2016-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437660057 | Iha Health Services Corporation | Surgery | 5333 Mcauley Dr Rm 4016, Ypsilanti, MI 48197-1001 | 2017-10-23 |
| 1760900138 | Integrated Vascular Vein Center of Michigan PC | Surgery | 600 Health Park Blvd Ste G, Grand Blanc, MI 48439-2558 | 2017-09-06 |
| 1043676661 | Integrative Cardiovascular Health & Wellness | Surgery | 3250 Woods Way, Suite 9, Petoskey, MI 49770-7628 | 2016-01-12 |
| 1124411244 | Vascular Surgery Assoc, PC | Surgery | 1122 S Lapeer Rd Ste C, Lapeer, MI 48446-3387 | 2015-03-13 |
| 1013309988 | Bloomfield Vein & Vascular Pllc | Surgery | 43700 Woodward Ave Ste 207, Bloomfield Hills, MI 48302-5061 | 2015-03-02 |
| 1114288206 | Scott Bendix | Surgery | 28100 Grand River Ave Ste 200, Farmington Hills, MI 48336-5969 | 2012-06-05 |
| 1942561428 | Charles J Shanley Md PC | Surgery | 1001 Audubon Rd, Grosse Pointe, MI 48230-1406 | 2012-05-31 |
| 1508122995 | Robert J Cardwell Md Pllc | Surgery | 13312 Terry Dr, Shelby Township, MI 48315-5365 | 2012-04-10 |
| 1780919936 | Martin A V Tuma Md Vascular Surgery Pllc | Surgery | 22255 Greemfield Road #250, Southfield, MI 48075 | 2009-10-06 |
| 1437383197 | Barbara D'agnoluzzo Moreira | Surgery | 3663 Woodward Ave Ste 200, Wsu Detroit Medical Center, Detroit, MI 48201-2400 | 2009-05-11 |
| Find all providers with the same taxonomy | ||||
| City | WEST BLOOMFIELD |
| Zip Code | 48322 |
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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.