Kelly Phan Van, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

34.018222 Issued in OH

Practice address

546 Winter St Ste 100
Wooster, OH 44691-2339

Phone

(330) 202-5662

Fax

(330) 202-5663

NPI assigned

Apr 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Arizona College of Osteopathic Medicine Mid Western University, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bloomington Medical Services LLCGroup PAC ID 9032297627, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wooster Community Hospital Hospital, Wooster, OH, CCN 360036

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Bloomington Medical Services LLC

  • Internal Medicine Physician
  • Wooster, OH
  • NPI 1528246683
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• City of Wooster

  • General Acute Care Hospital
  • Wooster, OH
  • NPI 1437156247
  Care Compare affiliation

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1093344889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 WINTER ST STE 100",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912339",
            "telephone_number": "330-202-5662",
            "fax_number": "330-202-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 WINTER ST STE 100",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912339",
            "telephone_number": "330-202-5662",
            "fax_number": "330-202-5663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7488 State Route 241",
            "address_purpose": "LOCATION",
            "city": "Millersburg",
            "state": "OH",
            "postal_code": "446548383",
            "country_code": "US",
            "telephone_number": "330-202-5662",
            "fax_number": "330-202-5663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN",
        "first_name": "KELLY",
        "middle_name": "PHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "34.018222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri Lee Uresti
• Reyna Orquidia Valdez, QMHS-BA
• Michele Valois, LPCC
• Kristin Van Dyke
• Kendra Jean Van Zile, QMHS-HS
• Duane Vance
• Bailey Robin Vandyne
• Morgan Vanmeter, SLP
• Bridget Varnes
• Bailey Vaughn

• Obstetrics & Gynecology Physician in Wooster, OH
• Providers in Wooster, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.