Kevin M Kiley, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301052245 Issued in MI

Practice address

1909 Ruddiman Drive
North Muskegon, MI 49445

Phone

(231) 744-5577

Fax

(231) 744-8777

NPI assigned

Jul 28, 2006

Last updated

Feb 7, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kevin.kiley.1@15079.direct.athenahealth.com

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1063426468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431848",
            "telephone_number": "231-727-5211",
            "fax_number": "231-727-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 RUDDIMAN DRIVE",
            "city": "NORTH MUSKEGON",
            "state": "MI",
            "postal_code": "49445",
            "telephone_number": "231-744-5577",
            "fax_number": "231-744-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILEY",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301052245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4556422",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Hollman, PHARMD
• HPCN (Harbour View Family Medicine)
• Laura Ann Inman, LLPC
• Holly Kendra, ND
• Kevin Kellogg MD PLC
• Erin Melissa Losee, FNP-C
• Mantych Psychotherapy, LLC (Anne Tyson, LMSW LLC)
• Meijer Inc (Meijer Pharmacy #071)
• Mercy Health
• Northcrest Operating Co., Inc. (Northcrest Assisted Living Community)

• Family Medicine Physician in North Muskegon, MI
• Providers in North Muskegon, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.