Kelsey Ann Spencer

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704358989 Issued in MI

Practice address

2861 Coppergrove Dr NE
Grand Rapids, MI 49525-3170

Phone

(616) 901-8564

NPI assigned

Nov 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kelsey Ann Jantz Professional name

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Psychiatry Specialists of Grand Rapids, PLLCGroup PAC ID 7911354832, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjantz3092517@direct.trinity-health.org

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.

• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Psychiatry Specialists of Grand Rapids, PLLC

  • Certified Registered Nurse Anesthetist
  • Grand Rapids, MI
  • NPI 1710638960
  Medicare reassignment Care Compare group NPD
• Iha Health Service Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  • Urgent Care Clinic/Center
  • Ann Arbor, MI
  • NPI 1992937023
  NPD

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1073387759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11681 64TH AVE",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018477",
            "telephone_number": "616-901-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 COPPERGROVE DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495253170",
            "telephone_number": "616-901-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "KELSEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704358989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "JANTZ",
            "middle_name": "ANN",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rebecca Sue Spence, RN,C
• Pamela A Spencer-Kelly, BSW, LMT
• Alexis Vernice Spencer
• Amy Riley Spencer, MD
• Christien Spencer, CTRS
• Lynne Spencer, CPO
• Sarah Lyn Spencer, MS, RDN
• Kara Spenski, NP
• Spero Psychiatric Services PLLC
• Elizabeth J Sperry, NP

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.